Cholestyramine
Severe
Database
40% reduction in MPA levels, rejection risk
Avoid combination.
Drug reference
Mycophenolate
Immunosuppressant
Also known as Mycophenolate mofetil
Immunosuppressant
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
1 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 3 →
- CholestyramineSevereDatabase
Mechanism
Mycophenolate mofetil is metabolized to mycophenolic acid, which is a more selective purine synthesis inhibitor than azathioprine. This action suppresses immune cell proliferation and function.
Indications
Prophylaxis of acute rejection in renal transplantation (in combination with a corticosteroid and ciclosporin)
Dosing
- Adult
- Oral: 1 g twice daily, to be started within 72 hours of transplantation. Intravenous infusion: 1 g twice daily for maximum 14 days, then transfer to oral therapy (to be started within 72 hours of transplantation).
Pharmacokinetics
Bioavailability
MM: ∼0%; MPA: 94%
Protein binding
MPA: 97.5%
Metabolism
Metabolized to mycophenolic acid
Excretion
MPA: <1%
Side effects
Common
Opportunistic infectionsLeucopenia
Serious
- Tissue-invasive cytomegalovirus infection
Pregnancy & lactation
Lactation
Manufacturer advises avoid—no information available.
Drug interactions
Acyclovir
Moderate
Database
Increased levels of both, AKI risk
Monitor renal function. Adjust doses in CKI.
Antacid
Moderate
Database
Reduced immunosuppression
Separate doses by 2 hours.
Related guidelines
Coronary angiography with renal dysfunction
CSI · Cardiology · 2020
Venous thromboembolism prophylaxis
ASH · Haematology · 2018
Acute kidney injury
KDIGO · Nephrology · 2012
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Infective endocarditis prevention
AHA · Cardiology / Dentistry · 2007
Other Immunosuppressant drugs
Ask House about Mycophenolate
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Sources: Goodman & Gilman 14e, Katzung, BNF, Nelson·Verified: 2026-05-10 · House clinical team