No clinically significant pharmacokinetic interaction appears to occur between aciclovir and mycophenolate. However, the manufacturers say that in renal impair- ment there may be competition for tubular secretion and increased concentrations of both drugs may occur. This is also possible with valaciclovir. A case report describes neutropenia in a patient taking valaciclovir with mycophenolate.
No action is needed, but increased monitoring may be prudent in patients with reduced renal function. Neutropenia is a rare adverse effect of valaciclovir alone. Nevertheless, bear the possibility of an interaction in mind should neutropenia occur if mycophenolate is also given.
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