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Drug Interactions between CellCept and valganciclovir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

mycophenolate mofetil valGANciclovir

Applies to: CellCept (mycophenolate mofetil) and valganciclovir

MONITOR: Data from a single-dose study do not suggest the potential for a clinically significant pharmacokinetic interaction between mycophenolic acid and ganciclovir in patients with normal renal function. However, since ganciclovir and the glucuronide metabolite of mycophenolic acid are both eliminated primarily by the kidney, plasma levels of both may increase in renal impairment due to competition for renal tubular secretion. In addition, use of mycophenolic acid and ganciclovir may increase the risk and severity of hematologic toxicity due to additive myelosuppressive effects.

MANAGEMENT: Caution is advised if ganciclovir or its prodrug, valganciclovir, must be used concomitantly with mycophenolic acid products in patients with impaired renal function. Close monitoring for toxicities such as myelo- and immunosuppression is recommended.

References (6)
  1. (2001) "Product Information. CellCept (mycophenolate mofetil)." Roche Laboratories
  2. Wolfe EJ, Mathur V, Tomlanovich S, Jung D, Wong R, Griffy K, Aweeka FT (1997) "Pharmacokinetics of mycophenolate mofetil and intravenous ganciclovir alone and in combination in renal transplant recipients." Pharmacotherapy, 17, p. 591-8
  3. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories
  4. (2004) "Product Information. Myfortic (mycophenolic acid)." Novartis Pharmaceuticals
  5. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  6. Cerner Multum, Inc. "Australian Product Information."

Drug and food interactions

Moderate

valGANciclovir food

Applies to: valganciclovir

ADJUST DOSING INTERVAL: Food increases the bioavailability of ganciclovir from the prodrug, valganciclovir. In 16 HIV-positive subjects, the administration of valganciclovir 875 mg once daily with a high-fat meal containing approximately 600 calories resulted in a 30% increase in the steady-state area under the plasma concentration-time curve (AUC) and a 14% increase in the peak plasma concentration (Cmax) of ganciclovir, with no delay in the time to reach peak plasma concentration (Tmax). The mechanism is unknown.

MANAGEMENT: The manufacturer recommends that valganciclovir be taken with meals.

References (2)
  1. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories
  2. Brown F, Banken L, Saywell K, Arum I (1999) "Pharmacokinetics of valganciclovir and ganciclovir following multiple oral dosages of valganciclovir in HIV- and CMV-seropositiv volunteers." Clin Pharmacokinet, 37, p. 167-76

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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