Valaciclovir Mycophenolate

ACICLOVIR/ VALACICLOVIR ANTICANCER AND IMMUNOMODULATING DRUGS- 1. CICLOSPORIN 2. MYCOPHENOLATE 3. TACROLIMUS 1.1 nephrotoxicity 2. Possible T efficacy 3. t levels with protease inhibitors 1. Additive side-effect 2. Competition for renal excretion 3. Inhibition of CYP3A4-mediated metabolism of tacrolimus 1. Monitor renal function prior to concomitant therapy and monitor cidosporin levels 2. Monitor renal function particularly if on >4g valaciclovir 1 dose of aciclovir if there is a background of renal failure 3. Monitor clinical effects closely check levels... 

MYCOPHENOLATE ANTIVIRALS-ACICLOVIR, GANCICLOVIR Possible T efficacy Competition for renal excretion Monitor renal function, particularly if on >4g valaciclovir. i dose of aciclovir if there is a background of renal failure... 

The concurrent use of aciclovir or ganciclovir and mycophenolate mofetil does not appear to significantly affect the pharmacokinetics of either drug, but the manufacturers recommend care in renal impairment. There are reports of neutropenia in patients taking mycophenolate with valaciclovir or ganciclovir. 

Gimenez F, Foeillet E, Bourdon O, Weller S, Garret C, Bidault R, Singlas E. Evaluation of pharmacokinetic interactions after oral administration of mycophenolate mofetil and valaciclovir or aciclovir to healftiy subjects. Clin Pharmacokinet (2004) 43, 685-92. 

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