OBJECT DRUGS

• Mycophenolate (CellCept, etc.)

PRECIPITANT DRUGS

Gastric Antisecretory Agents:

• Cimetidine (Tagamet, etc.)
• Dexlansoprazole (Kapidex)
• Esomeprazole (Nexium, etc.)
• Famotidine (Pepcid, etc.)
• Lansoprazole (Prevacid, etc.)
• Nizatidine (Axid, etc.)
• Omeprazole (Prilosec, etc.)
• Pantoprazole (Protonix, etc.)
• Rabeprazole (Aciphex)
• Ranitidine (Zantac, etc.)

Comment:

Mycophenolate dissolution is reduced by agents that increase gastric pH resulting in a reduction of mycophenolate absorption and plasma concentration of mycophenolate.

Class 3: Assess Risk & Take Action if Necessary

• Consider Alternative: Enteric coated mycophenolate acid is not affected by changes in gastric acidity.
• Monitor: Monitor for altered immunosuppressive response if a gastric antisecretory agent is initiated, discontinued, or changed in dosage.