Drug General Information (ID: DDILGRMND6)
Drug Name			Mycophenolate mofetil		Drug Info		Magnesium hydroxide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Immunosuppressive Agents				Antacids/Laxatives
Structure

Mechanism of Mycophenolate mofetil-Magnesium hydroxide Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Mycophenolate mofetil				Magnesium hydroxide
Mechanism		Gastric pH sensitive				Gastric alkalinizer
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Mycophenolate mofetil due to altered gastric pH caused by Magnesium hydroxide

Recommended Action
Management		Patients treated with oral mycophenolic acid who require an antacid or antacid-containing preparation (e.g., didanosine buffered tablets or pediatric oral solution) should separate the administration times of the medications by at least two hours.

References
1	Bullingham R, Shah J, Goldblum R, Schiff M "Effects of food and antacid on the pharmacokinetics of single doses of mycophenolate mofetil in rheumatoid arthritis patients." Br J Clin Pharmacol 41 (1996): 513-6. [PMID: 8799515]
2	Lipsky JJ "Mycophenolate mofetil." Lancet 348 (1996): 1357-9. [PMID: 8918281]
3	Product Information. CellCept (mycophenolate mofetil). Roche Laboratories, Nutley, NJ.
4	Product Information. Myfortic (mycophenolic acid). Novartis Pharmaceuticals, East Hanover, NJ.