Mycophenolate mofetil

Generic name: Mycophenolate mofetil

Drug class: Immunosuppressant

Dosage form: Capsule, tablet, oral suspension, intravenous infusion

Route of administration: Oral, intravenous

Dose: Typically, 500 mg to 1.5 grams twice daily, depending on the condition and patient factors.

Mechanism of action: Mycophenolate mofetil is metabolized to mycophenolic acid, which inhibits inosine monophosphate dehydrogenase, a key enzyme in the de novo synthesis of guanine nucleotides. This inhibition selectively suppresses the proliferation of T and B lymphocytes, thereby reducing immune-mediated damage.

Drug usage cases:

• Prevention of organ rejection in kidney, heart, and liver transplant recipients
• Treatment of moderate to severe lupus nephritis
• Management of systemic sclerosis (scleroderma)
• Therapy for uveitis
• Off-label use in other autoimmune diseases such as rheumatoid arthritis and vasculitis

Drug contraindications:

• Hypersensitivity to mycophenolate mofetil or any component of the formulation
• Pregnancy and breastfeeding
• Active serious infections
• Severe bone marrow suppression

Side effects:

• Gastrointestinal disturbances: nausea, vomiting, diarrhea, abdominal pain
• Hematologic effects: leukopenia, anemia, thrombocytopenia
• Increased risk of infections due to immunosuppression
• Elevated liver enzymes indicating hepatotoxicity
• Headache, dizziness, insomnia
• Hypertension
• Skin reactions: rash, pruritus
• Teratogenic effects leading to birth defects if used during pregnancy

Warnings:

• Increased risk of serious infections, including viral, bacterial, fungal, and opportunistic infections
• Potential development of certain cancers, such as skin cancer and lymphoma
• Risk of Progressive Multifocal Leukoencephalopathy (PML), a rare and serious brain infection
• Use with caution in patients with a history of gastrointestinal ulcers or bleeding
• Monitor blood counts and liver function tests regularly during therapy
• Avoid live vaccines during treatment
• Use effective contraception during treatment and for a specified period after discontinuation due to teratogenicity

Use during pregnancy or breastfeeding:

Mycophenolate mofetil is contraindicated during pregnancy and breastfeeding due to its teratogenic effects, which can lead to birth defects. Women of childbearing potential should use effective contraception during treatment and for at least 6 weeks after discontinuation. Men should also use contraception during treatment and for at least 90 days after discontinuation. Breastfeeding is not recommended during treatment with mycophenolate mofetil.