Immunosuppressive agent, ester of mycophenolic acid, a mycotoxin.
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Mycophenolate mofetil
DefinitionThis section has been translated automatically.
Half-lifeThis section has been translated automatically.
< 2 minutes.
Pharmacodynamics (Effect)This section has been translated automatically.
Specific, non-competitive, reversible inhibitor of inosine monophosphate dehydrogenase, which is a key enzyme of guanosine nucleotide synthesis in T and B lymphocytes.
Antiproliferative effect on lymphocytes and immunosuppressive effect by inhibiting antibody formation. Inhibition of mitogen- or antigen-stimulated proliferation of B and T lymphocytes, antigen-induced production of antibodies by B lymphocytes, mast cell degranulation, and lipoxygenase. The influence on cytokine production is still unclear.
IndicationThis section has been translated automatically.
Prophylaxis of transplant rejection reactions after kidney transplantation. In clinical trials for the therapy of autoimmune diseases, e.g. severe psoriasis and autoimmune dermatoses.
Limited indicationThis section has been translated automatically.
Women of childbearing age, renal insufficiency.
Dosage and method of useThis section has been translated automatically.
- Psoriasis: Initial 2 times/day 1 g p.o. for 3 weeks, then 2 times/day 0.5 g p.o. for 3 weeks.
- Psoriasis arthropathica: combination with low-dose acitretin (0.1-0.2 mg/kg bw/day p.o.)
- Bullous pemphigoid: 1.0 g/2 times/day p.o. in combination with prednisolone 2 mg/kg bw/day p.o. Subsequently reduction of glucocorticoid.
- Pemphigus vulgaris: 1,0 g/2 times/day p.o. in combination with prednisolone 2 mg/kg bw/day p.o. Followed by reduction of the glucocorticoid.
- Systemic vasculitis and systemic lupus erythematosus: 1.0 g/2 times/day p.o. in combination with prednisolone.
- Pyoderma gangraenosum: If necessary, combination of mycophenolate mofetil 1.0 g/2 times/day p.o., Ciclosporin A 50-100 mg/day total dose and prednisolone.
- Pfeifer-Weber-Christian-Syndrome: In severe cases and poor response to therapy with prednisolone/azathioprine or methotrexate. 1.0 g/2 times/day p.o. Mycophenolate mofetil in combination with prednisolone 2.0 mg/kg bw/day.
- Dyshidrotic eczema: initial 1.5 g/2 times/day, after 4 weeks 1.0 g/2 times/day p.o.
- Dermatomyositis: 1.0 g/2 times/day p.o. Mycophenolate mofetil in combination with prednisolone.
Notice! In women of childbearing age, pregnancy must be ruled out before therapy and effective contraception must be used during therapy!
Undesirable effectsThis section has been translated automatically.
See table 1: With increasing duration of treatment, the complaints predominantly decrease.
InteractionsThis section has been translated automatically.
Increase in acyclovir levels. If retinoids are administered simultaneously, altered action levels may occur, as both drugs bind to albumin in 98% of cases.
ContraindicationThis section has been translated automatically.
Pregnancy, nursing.
PreparationsThis section has been translated automatically.
CellCept
Note(s)This section has been translated automatically.
Unfortunately, there is no reliable correlation between MPA serum levels and treatment efficiency. Serum levels are therefore an insufficient prognostic factor with regard to efficiency or expected side effects, but a method for checking compliance.
LiteratureThis section has been translated automatically.
- Baskan EB et al (2003) Effective treatment of relapsing idiopathic nodular panniculitis (Pfeifer-Weber-Christian disease) with mycophenolate mofetil. J Dermatolog Treat 14: 57-60
- Daudén E et al (2004) Plasma trough levels of mycophenolic acid do not correlate with efficacy and safety of mycophenolate mofetil in psoriasis. Br J Dermatol 150: 132-135
- Geilen CC et al (2000) Mycophenolate mofetil: a new immunosuppressive drug in dermatology and its possible uses. dermatologist 51: 63-69
- Michel S et al (1999) Therapy-resistant pyoderma gangrenosum--treatment with mycophenolate mofetil and cyclosporine A. Dermatologist 50: 428-431
- Mimouni D et al (2003) Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil. Arch Dermatol 139: 739-742
- Moder KG et al (2003) Mycophenolate mofetil: new applications for this immunosuppressant. Ann Allergy Asthma Immunol 90: 15-19
- Powell AM et al (2003) An evaluation of the usefulness of mycophenolate mofetil in pemphigus. Br J Dermatol 149: 138-145
- Reynaert S et al (2003) Successful treatment of two patients with pyoderma gangraenosum using mycophenolate mofetil. Br J Dermatol 149(Suppl 64): 25
- Trebing D et al (2001) Acquired epidermolysis bullosa with a highly varied clinical picture and successful treatment with mycophenolate mofetil. dermatologist 52: 717-721
TablesThis section has been translated automatically.
Possible side effects of Mycophenolatmofetil
Airways |
bronchial asthma, dyspnoea, cough, flu-like symptoms, respiratory infections, pulmonary oedema, pleural effusion, rhinitis, sinusitis |
Blood, lymph |
Anemia, blood formation disorders, leukopenia, thrombocytopenia, hypalbuminemia, lymphoproliferative diseases |
GIT |
Abdominal pain, gastrointestinal disturbances, AP increase, transaminase increase, hepatitis, ileus |
Urinary tract |
Albuminuria, dysuria, haematuria, pollakiuria, urinary tract infections, hydronephrosis, pyelonephritis, serum creatinine increase, tubule necrosis |
Skin |
acne, alopecia, hirsutism, candidiasis, exanthema, pruritus, spinocellular carcinoma, herpes simplex, herpes zoster, ecchymosis, skin ulcerations, stomatitis, gingivitis, gingival hyperplasia, impotence |
Cardiovascular |
Angina pectoris, drop in blood pressure, leg edema, hypertension, palpitations, tachycardia, atrial fibrillation |
Nervous System |
Anxiety, depression, impaired responsiveness, headaches, myasthenia, paresthesia, tremor, sleep disorders |
Sensory Organs |
Amblyopia, cataract, conjunctivitis, dizziness |
Metabolism, Endocrinium |
acidosis, exsiccosis, diabetes mellitus, weight gain, hypercholesterolemia, hyperkalemia, hypercalcaemia, hypophosphataemia |
Support apparatus |
Arthralgia, myalgia, leg pain, back pain |
System reactions |
Fever, malaise, sepsis, malignancies, progressive multifocal leukoencephalopathy (PML) |