Drug interactions
Mycophenolate mofetil + Nirmatrelvir / ritonavir
Severity: Minor
Mycophenolate mofetil and Nirmatrelvir / ritonavir: minor 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
Ritonavir may alter mycophenolic acid exposure through effects on glucuronidation and transporters, but the direction and size of the change are unpredictable. The short course of nirmatrelvir/ritonavir limits the likely impact.
What this interaction means in plain words
Mycophenolate mofetil and Nirmatrelvir / ritonavir have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Ritonavir may modulate UGT-mediated glucuronidation and transport of mycophenolic acid; the effect is not well characterised.
What to do
No empirical dose change is required; monitor for mycophenolate toxicity such as cytopenias or gastrointestinal effects during and after the course.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Mycophenolate mofetil
- Adenovirus types 4 and 7 live + Mycophenolate mofetil Contraindicated
- Bcg vaccine live + Mycophenolate mofetil Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Mycophenolate mofetil Contraindicated
- Measles mumps and rubella vaccine live + Mycophenolate mofetil Contraindicated
- Measles mumps rubella and varicella vaccine live + Mycophenolate mofetil Contraindicated
- Measles vaccine + Mycophenolate mofetil Contraindicated
Frequently asked questions
Can I take Mycophenolate mofetil with Nirmatrelvir / ritonavir?
MediHelp rates the interaction as minor. Mycophenolate mofetil and Nirmatrelvir / ritonavir have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Ritonavir may alter mycophenolic acid exposure through effects on glucuronidation and transporters, but the direction and size of the change are unpredictable. The short course of nirmatrelvir/ritonavir limits the likely impact.
How serious is the interaction between Mycophenolate mofetil and Nirmatrelvir / ritonavir?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No empirical dose change is required; monitor for mycophenolate toxicity such as cytopenias or gastrointestinal effects during and after the course.
What other medicines interact with Mycophenolate mofetil?
MediHelp also lists interactions of Mycophenolate mofetil with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Mycophenolate mofetil page.
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