Prescription ·Strong evidence ·Reviewed May 2026
Mycophenolate mofetil is an immunosuppressive prodrug of mycophenolic acid used to prevent organ transplant rejection in combination regimens. It carries boxed warnings for embryofetal toxicity, malignancies, and serious infections, and its absorption can be reduced by magnesium/aluminum antacids and some binders.
The bottom line
Evidence rating strong. Most-documented uses: prevention of kidney transplant rejection, prevention of heart transplant rejection, prevention of liver transplant rejection. 3 sources indexed (1996–2026), with 2 interaction records on file.
Core mechanism
Mycophenolate mofetil is hydrolyzed to mycophenolic acid, a selective, reversible inhibitor of inosine monophosphate dehydrogenase. This blocks de novo guanosine nucleotide synthesis, which T and B lymphocytes rely on heavily for proliferation. Enterohepatic recirculation contributes to exposure, and antacid or binder effects can reduce absorption.1,3
Often taken on an empty stomach for consistency, but may be taken with food if needed for gastrointestinal tolerability if the transplant team agrees. Separate from magnesium/aluminum antacids and binders that can reduce absorption.
Magnesium/aluminum antacids can reduce mycophenolate absorption and lower mycophenolic acid exposure; ordinary magnesium supplements are less directly studied but should not be taken simultaneously without transplant-team instructions.
Recommendation: Separate magnesium-containing products from mycophenolate by at least 2 hours unless the transplant team gives different instructions.
Live probiotics rarely cause invasive infection in severely immunosuppressed patients.
Recommendation: Avoid unsupervised probiotics during intense immunosuppression, neutropenia, central lines, or severe illness.
Search all 2 interaction records for Mycophenolate Mofetil →
Numbered references. Citations throughout the page link here.
Pivotal transplant trials established efficacy for rejection prophylaxis.
Guideline supports monitoring blood counts, infections, malignancy prevention, and drug interactions in transplant care.
Labeling describes transplant indications, boxed warnings, pregnancy testing and contraception requirements, cytopenias, infections, and absorption interactions.
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