Mycophenolate Mofetil

MMF

Mechanism :

Mycophenolate mofetil is a potent, selective, uncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), and therefore inhibits the de novo pathway of guanosine nucleotide synthesis without incorporation into DNA. Because T- and B-lymphocytes are critically dependent for their proliferation on de novo synthesis of purines, whereas other cell types can utilize salvage pathways, it has potent cytostatic effects on lymphocytes.

Indication :

• Cardiac transplant
• Renal transplant
• Liver transplant
• Steroid resistant nephrotic syndrome

Contraindications :

Contraindicated in patients with a hypersensitivity to mycophenolate mofetil, mycophenolic acid or any component of the drug product. With other immunosuppressive treatments, patients treated with mycophenolate are at increased risk of developing lymphomas, and other malignancies, particularly of the skin. Patients should avoid exposure to strong sunlight. Administer with caution in patients with active gastrointestinal disease. Gastrointestinal perforation has been reported.

Dosing :

Adverse Effect :

Leukopenia, sepsis, opportunistic infection, fever, back pain, abdominal and generalized pain, headache, asthenia, peripheral oedema, anemia, hypochromic anemia, leukopenia, leucocytosis, thrombocytopenia, renal tubular necrosis, haematuria, hypertension, hypo and hyperkalemia, hyperglycemia, hypophosphatemia, hypercholesterolemia, hypomagnesemia, peripheral edema, diarrhea, nausea, vomiting, bleeding, constipation, dyspepsia, melanoma, acne, dizziness, insomnia, tremor.

Interaction :

Food: Reduces the peak plasma level but does not reduce total absorption.
Cholestyramine: Significantly impairs the absorption of mycophenolate.
Antacids: Absorption is impaired if given at the same time as antacids containing magnesium or aluminium hydroxides. A sufficient Interval should be allowed between giving each drug.
Acyclovir, Ganciclovir: Concurrent administration with acyclovir, ganciclovir can result in higher plasma concentrations of all three drugs.

Renal Dose :

Hepatic Dose :