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A neutropenia suggesting an interaction between valacyclovir and mycophenolate mofetil
Bernard Royer1, Gilbert Zanetta, Michel Bérard
1Pharmacology Department, Jean Minjoz University Hospital, Besançon, France. bernard.royer@ufc-chu.univ-fcomte.fr
Clinical Transplantation
|April 24, 2003
Summary
Mycophenolate mofetil and valacyclovir combination therapy may cause neutropenia. This adverse effect might stem from mycophenolate increasing valacyclovir levels, requiring further investigation.
Area of Science:
- Pharmacology
- Nephrology
- Immunosuppression
Background:
- Mycophenolate mofetil (MMF) is crucial in preventing renal transplant rejection.
- Cytomegalovirus infections are common in MMF recipients, often necessitating antiviral prophylaxis with valacyclovir.
Observation:
- A case of neutropenia was observed in a patient receiving both MMF and valacyclovir.
- Neutropenia duration correlated with valacyclovir treatment, and MMF levels fluctuated with neutrophil counts.
Findings:
- Initial assessment suggested valacyclovir as the cause of neutropenia.
- Literature review and case analysis indicated a potential drug interaction between MMF and valacyclovir.
Implications:
- MMF may increase intracellular valacyclovir concentrations to potentially toxic levels.
- This interaction could explain the observed neutropenia, warranting further research and clinical vigilance.