Norfloxacin Mycophenolate

MYCOPHENOLATE METRONIDAZOLE, NORFLOXACIN, RIFAMPICIN Significant 1 plasma mycophenolate concentrations (>60% with rifampicin) Inhibition of metabolism of mycophenolate Avoid co-administration... 

Naderer OJ, Dupuis RE, Heinzen EL, Wiwattanawongsa MS, Johnson MW, Smith PC. The influence of norfloxacin and metronidazole on the disposition of mycophenolate mofetil. J Clin Pharmacol (2005) 45, 219-26. 

A study in 11 healthy subjects found that norfloxacin 400 mg twice daily reduced the AUC of a single 1-g oral dose of mycophenolate mofetil given two hours after the antibacterial on day 4 by 10%. The AUC of the glucuronide metabolite was also reduced by 10%. When norfloxacin 400 mg twice daily was also given, the AUC of mycophenolate and its glucuronide metabolite were reduced by 33% and 41%, respectively. This interaction was thought to be due to interference of the enterohepatic recirculation of mycophenolate by the antibacterials. There appear to be no further clinical reports of an interaction between these antibacterials and mycophenolate. The changes with norfloxacin alone were modest, and unlikely to be... 

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