Mycophenolate Mofetil Mshael AL-Bargawi
Brand Names: CellCept . Description It is an immunosuppressive agents used to lower the body's natural immunity in patients who receive organ transplants.
CHEMICAL STRUCTRE: C23H31NO
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 ADMINISTRAION: **Orally : (twice a day ) -Oral tablet : 500 mg . -Oral capsule : 250 mg . -Oral powder for suspension : 200 mg/ml . **Intravenous: 500 mg vial to be reconstituted 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 bioavailability after oral application in general is rapid . -It is highly bound to plasma proteins . -It hydrolyzed to form (MPA), the active metabolite, 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 other substances, such as food preservatives or dyes . 4-Children . 5-Older adults .
calcineurin inhibitors DRUG INTERACTIONS: Reduced the action Improves the action magnesium hydroxide Cyclosporine Aluminium hydroxide voriconazole Cholysteramine steroids Oral contraceptives calcineurin inhibitors FK506 tacrolimus Azathioprine allopurinol
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