View source for Mycophenolate mofetil

==Administration==
*Type: Immunosuppressant
*Dosage Forms: 250,500; 200 mg/mL; IV
*Routes of Administration: PO, IV
*Common Trade Names: CellCept

==Adult Dosing==
===Kidney transplant rejection prophylaxis===
*1 g PO/IV bid
*Start: IV with in 24h post transplant, continue up to 14 days, switch to PO ASAP; Info: give on empty stomach; stable patients may take with food

===Heart transplant rejection prophylaxis===
*1.5 g PO/IV bid
*Start: IV with in 24h post transplant, continue up to 14 days, switch to PO ASAP; Info: give on empty stomach

===Liver transplant rejection prophylaxis===
*1.5 g PO bid or 1 g IV bid
*Info: start IV with in 24h post transplant, continue up to 14 days, switch to PO ASAP; Info: give on empty stomach

===Lupus nephritis===
*1 g PO bid
*Info: use with prednisone, consider decease dose 50% after 6mo treatment

==Pediatric Dosing==
===Kidney transplant rejection prophylaxis===
*3 mo-18 yo: Dose: 600 mg/m^2 PO bid; Alt: 750 mg PO bid for body surf. area = 1.25-1.5 m^2; 1 g PO bid for body surf. area >1.5 m^2; Max: 1 g/dose

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D
*[[Lactation risk categories|Lactation risk]]: possibly unsafe
===Renal Dosing===
*Adult:
**kidney transplant patients, delayed graft function immediate postop: no adjustment
**kidney transplant patients, outside immediate post-transplant period:CrCl <25: max 1 g bid; HD/PD: no supplement
**heart or liver transplant patients: CrCl <25: weigh risk/benefit; HD/PD: not defined
*Pediatric:
**kidney transplant patients, delayed graft function immediate postop: no adjustment
**kidney transplant patients, outside immediate post-transplant period: CrCl <30: max 600 mg/m^2/day; HD/PD: no supplement

===Hepatic Dosing===
*Adult: renal transplant with severe hepatic parenchymal disease: no adjustment; other hepatic impairment: not defined
*Pediatric: renal transplant with severe hepatic parenchymal disease: no adjustment; other hepatic impairment: not defined

==Contraindications==
*Allergy to class/drug
*hypersens. to polysorbate 80 (IV form)
*Lesch-Nyhan syndrome
*Kelly-Seegmiller syndrome
*caution in elderly patients
*caution if GI disorder
*caution if renal disease, severe
*caution if bone marrow depression
*caution if PKU (phenylalanine-containing forms)

==Adverse Reactions==
===Serious===
*thrombocytopenia
*leukopenia
*neutropenia
*immunosuppression
*infection, severe
*opportunistic infection
*viral reactivation
*polyomavirus-assoc. nephropathy
*PML
*pure red cell aplasia
*lymphoma
*lymphoproliferative disorders
*malignancy
*GI bleeding
*GI perforation/ulcer
*colitis
*acute renal failure
*interstitial lung disease
*pregnancy loss, 1st trimester
*congenital malformations

===Common===
*HTN
*infection
*diarrhea
*peripheral edema
*anemia
*abdominal pain
*constipation
*leukopenia
*fever
*headache
*nausea/vomiting
*dyspepsia
*hypotension (rapid IV use)
*dyspnea
*cough
*hypercholesterolemia
*hypokalemia
*tremor
*acne
*insomnia

==Pharmacology==
*Half-life: 17.9h (PO route), 16.6h (IV route)
*Metabolism: liver; CYP450: Info: prodrug converted to mycophenolic acid (MPA)
*Excretion: urine 93% (<1% unchanged), feces 6%

==Mechanism of Action==
inhibits B- and T-lymphocyte proliferation

==Comments==

==See Also==

==References==
<references/>
[[Category:Pharmacology]]
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