Drug interactions
Mycophenolic acid + Rifampicin
Severity: Major
Mycophenolic acid and Rifampicin: major 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
Rifampicin can lower mycophenolic acid exposure, which may reduce immunosuppression and raise the risk of rejection or graft-versus-host disease. The effect has been seen in transplant recipients and may emerge within days of starting rifampicin.
What this interaction means in plain words
Mycophenolic acid and Rifampicin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Mycophenolic acid belongs to Miscellaneous; Rifampicin belongs to Anti Bacterial.
Why it happens
Rifampicin induces UGT enzymes and may alter enterohepatic recirculation of mycophenolic acid glucuronide, lowering its exposure.
What to do
Avoid the combination unless clearly needed; if used, monitor for rejection and consider mycophenolic acid exposure monitoring with dose adjustment. Re-evaluate dosing when rifampicin is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Mycophenolic acid
Other interactions of Rifampicin
- Cabotegravir + Rifampicin Contraindicated
- Delamanid + Rifampicin Contraindicated
- Doravirine + Rifampicin Contraindicated
- Ensitrelvir + Rifampicin Contraindicated
- Fostemsavir + Rifampicin Contraindicated
- Isavuconazole + Rifampicin Contraindicated
Frequently asked questions
Can I take Mycophenolic acid with Rifampicin?
MediHelp rates the interaction as major. Mycophenolic acid and Rifampicin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Rifampicin can lower mycophenolic acid exposure, which may reduce immunosuppression and raise the risk of rejection or graft-versus-host disease. The effect has been seen in transplant recipients and may emerge within days of starting rifampicin.
How serious is the interaction between Mycophenolic acid and Rifampicin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination unless clearly needed; if used, monitor for rejection and consider mycophenolic acid exposure monitoring with dose adjustment. Re-evaluate dosing when rifampicin is stopped.
What other medicines interact with Mycophenolic acid?
MediHelp also lists interactions of Mycophenolic acid with, for example, Activated charcoal, Azathioprine, Cholestyramine. The full list is on the Mycophenolic acid page.
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