Mycophenolate MofetilMycophenolate Mofetil

Mshael AL-BargawiMshael AL-Bargawi

Brand Names:Brand Names:CellCeptCellCept . .

DescriptionIt is an immunosuppressive agents used to lower the body's natural immunity in patients who receive organ transplants.

CHEMICAL STRUCTRECHEMICAL STRUCTRE::

C23H31NOC23H31NO

Therapeutic uses: 1 _It used to prevent the body

rejection of a solid organ transplant such as:

-Kidney. - Heart .

-Liver. -Lunge and Pancreas .

2_In treatment of uveitis

3_In treatment of nephritis.

4_ In the treatment of several types of vasculitis .

5 _Treatment of psoriasis.

DOSE AND ADMINISTRAIONDOSE AND ADMINISTRAION::

**Orally :**Orally : (twice a day ) (twice a day )--Oral tabletOral tablet : : 500 500 mgmg . .-Oral capsule-Oral capsule : : 250 mg .250 mg .-Oral powder for suspension -Oral powder for suspension : : 200 mg/ml .200 mg/ml .**Intravenous:**Intravenous: 500 mg vial to be 500 mg vial to be

reconstituted in 14 ml of D5Wreconstituted in 14 ml of D5W . .

MECHANISM OF ACTION:

-MMF is a semisynthetic derivative of MPA.

-It is a potent reversible ,selective.

-Noncompetitive inhibitor of the enzyme inosine monophosphate dehydrogenase .

Blocking the de novo formation of GMP Deprivation of proliferation Tand B-cell of nucleic acid.

PHARMACOKINETICS:

-It used orally or I.V but the bioavailabilityafter oral application in general is rapid .-It is highly bound to plasma proteins .-It hydrolyzed to form (MPA), the activemetabolite, by gut wall , liver, peripheal tissues, and plasma esterases . -It is mainly metabolized in the liver and excretion by Kidney .

-

MAIN SIDE EFFEECTS: 1-In GIT : ( nausea, vomiting,

diarrhea,urinary tract infection, abdominal pain, loose bowel-movements and cramping).

2-Myelosuppression : including leukopenia , thrombocytopenia and anemia.

3 -bone marrow suppression. 4-peripheral edema.

5-Malignancy : like non-Hodgkin’s lymphomas .

CONTRAINDICATION:1-Pregnancy.

2-Breast-feeding .

3-Allergies :to mycophenolate or any othersubstances, such as food preservatives ordyes .4-Children .

5-Older adults .

DRUG INTERACTIONSDRUG INTERACTIONS::

Improves the actionImproves the actionReduced the actionReduced the actionCyclosporineCyclosporine magnesiummagnesium hydroxidehydroxide voriconazolevoriconazole Aluminium hydroxideAluminium hydroxide

steroidssteroids CholysteramineCholysteramine

calcineurin inhibitorscalcineurin inhibitors Oral contraceptivesOral contraceptives

FK506FK506tacrolimustacrolimus

AzathioprineAzathioprine

allopurinolallopurinol

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