Drug interactions
Ampicillin-sulbactam + Mycophenolate
Severity: Moderate
Ampicillin-sulbactam and Mycophenolate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Antibiotics, including ampicillin, may reduce mycophenolic acid exposure by disrupting gut bacteria that deconjugate the glucuronide for enterohepatic recycling. This may lower immunosuppression, although the effect is variable and the renal-clearance explanation is unsupported.
What this interaction means in plain words
Ampicillin-sulbactam and Mycophenolate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Gut flora suppression reduces enterohepatic recirculation of mycophenolic acid glucuronide, lowering exposure.
What to do
Monitor for signs of reduced immunosuppression such as graft dysfunction, and consider mycophenolic acid level monitoring during and after the antibiotic course.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ampicillin-sulbactam
Frequently asked questions
Can I take Ampicillin-sulbactam with Mycophenolate?
MediHelp rates the interaction as moderate. Ampicillin-sulbactam and Mycophenolate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Antibiotics, including ampicillin, may reduce mycophenolic acid exposure by disrupting gut bacteria that deconjugate the glucuronide for enterohepatic recycling. This may lower immunosuppression, although the effect is variable and the renal-clearance explanation is unsupported.
How serious is the interaction between Ampicillin-sulbactam and Mycophenolate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of reduced immunosuppression such as graft dysfunction, and consider mycophenolic acid level monitoring during and after the antibiotic course.
What other medicines interact with Ampicillin-sulbactam?
MediHelp also lists interactions of Ampicillin-sulbactam with, for example, Methotrexate, Allopurinol, Bcg vaccine live. The full list is on the Ampicillin-sulbactam page.
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