Estradiol Topical and Mycophenolate Mofetil: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Estradiol Topical
Mycophenolate Mofetil
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced levonorgestrel exposure and reduced efficacy of combination oral contraceptive
Interaction Deep Dive
Coadministration of mycophenolate mofetil with combined oral contraceptives resulted in a significant decrease in exposure to levonorgestrel. Decreased exposure could result in reduced effectiveness of the combination contraceptive. Use additional barrier contraceptive methods when coadministration is required. In a study involving 18 women with psoriasis, coadministration of mycophenolate mofetil (1 g twice daily) and combined oral contraceptives containing ethinyl estradiol (0.02 mg to 0.04 mg) and levonorgestrel (0.05 mg and 0.2 mg), desogestrel (0.15 mg) or gestodene (0.05 mg to 0.1 mg) over 3 consecutive menstrual cycles resulted in a significant decrease in levonorgestrel AUC by approximately 15%. The mean AUC was similar for ethinyl estradiol and 3-keto desogestrel. There was large inter-patient variability (%CV in the range of 60% to 70%) in the data, especially for ethinyl estradiol. The mean serum levels of luteinizing hormone, follicle-stimulating hormone, and progesterone were not significantly affected12.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In a study involving 18 women with psoriasis, coadministration of mycophenolate mofetil (1 g twice daily) and combined oral contraceptives containing ethinyl estradiol (0.02 mg to 0.04 mg) and levonorgestrel (0.05 mg and 0.2 mg), desogestrel (0.15 mg) or gestodene (0.05 mg to 0.1 mg) over 3 consecutive menstrual cycles resulted in a significant decrease in levonorgestrel AUC by approximately 15%. The mean AUC was similar for ethinyl estradiol and 3-keto desogestrel. There was large inter-patient variability (%CV in the range of 60% to 70%) in the data, especially for ethinyl estradiol. The mean serum levels of luteinizing hormone, follicle-stimulating hormone, and progesterone were not significantly affected 12.
Common questions
Can I take Estradiol Topical and Mycophenolate Mofetil together?
Reduced levonorgestrel exposure and reduced efficacy of combination oral contraceptive Always confirm with your pharmacist or prescriber before making any change.
How serious is the Estradiol Topical and Mycophenolate Mofetil interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Estradiol Topical or Mycophenolate Mofetil need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: CELLCEPT(R) oral capsules, oral tablets, oral suspension, intravenous injection, mycophenolate mofetil oral capsules, oral tablets, oral suspension, intravenous injection. Genentech USA Inc (per FDA), South San Francisco, CA, 2022. DailyMed
- Product Information: MYHIBBIN oral suspension, mycophenolate mofetil oral suspension. Azurity Pharmaceuticals, Inc.(per Manufacturer), Woburn, MA, 2024. DailyMed
Keep reading about Estradiol Topical
Keep reading about Mycophenolate Mofetil
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