Drug reference

Mycophenolic Acid

Antimetabolite · Immunosuppressant

Also known as MYFORTIC, MPA, Mycophenolate mofetil, MMF, Ceptava, Mycophenolate Sodium

AntimetaboliteImmunosuppressant

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

Associated with congenital anomalies and increased risk of pregnancy loss. Women of childbearing potential must use effective contraception.

FDA category + note

Top interactionssee all 12 →

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Mechanism

Mycophenolic acid (MPA) is an immunosuppressant that selectively and reversibly inhibits inosine monophosphate dehydrogenase (IMPDH), an enzyme crucial for the de novo synthesis of guanosine nucleotides. Lymphocytes are highly dependent on this pathway for proliferation and function, making them particularly susceptible to MPA's effects. This inhibition leads to a reduction in lymphocyte proliferation and antibody formation, thereby suppressing immune responses.

Indications

Prophylaxis of acute rejection in renal transplantation (in combination with a corticosteroid and ciclosporin)Prophylaxis of acute rejection in cardiac transplantation (in combination with ciclosporin and corticosteroids)Prophylaxis of acute rejection in hepatic transplantation (in combination with ciclosporin and corticosteroids)Prevention of transplant rejection

Dosing

Adult: For renal transplantation: 720 mg twice daily by mouth, to be started within 72 hours of transplantation.

Pharmacokinetics

Peak effect

Delayed due to enteric coating (for delayed-release tablet form).

Metabolism

Converted to MPAG.

Excretion

Metabolite (MPAG) undergoes tubular secretion.

Contraindications

Active serious gastro-intestinal disease (risk of haemorrhage, ulceration and perforation)
Use in children (due to higher incidence of side-effects)
Use in elderly (due to increased risk of infection, gastro-intestinal haemorrhage and pulmonary oedema)
Pregnancy (associated with congenital anomalies and increased risk of pregnancy loss)
Women of childbearing potential not using effective contraception