Indication
Kindey transplant rejection
Administration
Drug is taken on empty stomach 1 hour before or 2 hours after meals
Adult Dose
Oral Adult Kidney transplant patients As Mycophenolic Acid (MPA) (As Mycophenolate sodium): 720 mg twice daily.
Child Dose
Oral Child Kidney transplant patients As Mycophenolic Acid (MPA) (As Mycophenolate sodium): 5 years or above: 400 mg/m2 twice daily.
Renal Dose
Renal impairment No dosage adjustment needed in renal transplant patients experiencing delayed graft function post-operatively.
Contraindication
Contraindicated to patients with hypersensitivity to mycophenolic acid or any of its excipients.
Mode of Action
Mycophenolic acid acts by blocking purine synthesis of human lymphocytes through reversible inhibition of inosine monophosphate dehydrogenase. It also inhibits proliferation of both T- and B- lymphocytes.
Precaution
Can cause embryofetal toxicity Increases new or reactive viral infection Cause blood dyscrasias Can cause serious GI tract complication Use of live vaccine should be avoided Active peptic ulcer disease. Severe renal impairment. Lactation: Unknown whether drug is excreted in breast milk; avoid using, or do not nurse
Side Effect
>10% Hyperglycemia (44%),Hypercholesterolemia (41%),Hypomagnesemia (39%),Dyspnea (37%),Back pain (35%),Increased blood urea nitrogen (BUN) (35%),Leukopenia (34%),Pleural effusion (34%),Urinary tract infection (34%),Increasing frequency of cough (31%),Hypocalcemia (30%),Hypertension (28%),Abdominal pain (27%),Peripheral edema (27%),Anemia (26%),Fever (23%),Nausea (23%),Hyperkalemia (22%),Diarrhea (21%),Infection (21%),Headache (16%) 1-10% Melanoma (1.6-4.2%),Other malignancies (0.7-2.1%),Lymphoma (0.4-1%),Opportunistic infection (including herpes),Neutropenia,GI bleeding,Pulmonary fibrosis,Progressive multifocal leukoencephalopathy Potentially Fatal: Angioedema, anaphylaxis, fatal pulmonary fibrosis.
Interaction
Increased plasma levels of both drugs when combined with aciclovir, valaciclovir, ganciclovir and valganciclovir. Reduced absorption with colestyramine, magnesium- and aluminium hydroxide-containing products, sevelamer and other calcium-free phosphate binders. Reduced plasma levels with ciclosporin, metronidazole, quinolones, rifamycins. May reduce plasma levels of progestins; may reduce efficacy of oral contraceptives. Increased plasma levels with probenecid. May reduce efficacy of live vaccines.