Mycophenolate mofetil

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 04.03.2021

Dieser Artikel auf Deutsch

Definition
This section has been translated automatically.

Immunosuppressive agent, ester of mycophenolic acid, a mycotoxin.

Half-life
This 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.

Indication
This 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 indication
This section has been translated automatically.

Women of childbearing age, renal insufficiency.

Dosage and method of use
This 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 effects
This section has been translated automatically.

See table 1: With increasing duration of treatment, the complaints predominantly decrease.

Interactions
This 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.

Contraindication
This section has been translated automatically.

Pregnancy, nursing.

Preparations
This 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.

Literature
This section has been translated automatically.

  1. 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
  2. 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
  3. Geilen CC et al (2000) Mycophenolate mofetil: a new immunosuppressive drug in dermatology and its possible uses. dermatologist 51: 63-69
  4. Michel S et al (1999) Therapy-resistant pyoderma gangrenosum--treatment with mycophenolate mofetil and cyclosporine A. Dermatologist 50: 428-431
  5. Mimouni D et al (2003) Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil. Arch Dermatol 139: 739-742
  6. Moder KG et al (2003) Mycophenolate mofetil: new applications for this immunosuppressant. Ann Allergy Asthma Immunol 90: 15-19
  7. Powell AM et al (2003) An evaluation of the usefulness of mycophenolate mofetil in pemphigus. Br J Dermatol 149: 138-145
  8. Reynaert S et al (2003) Successful treatment of two patients with pyoderma gangraenosum using mycophenolate mofetil. Br J Dermatol 149(Suppl 64): 25
  9. Trebing D et al (2001) Acquired epidermolysis bullosa with a highly varied clinical picture and successful treatment with mycophenolate mofetil. dermatologist 52: 717-721

Tables
This 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)

Authors

Last updated on: 04.03.2021