By Gary M. White, MD
Note, this is a brief summary only of mycophenolate mofetil (MM) and is meant to emphasize dermatologic aspects. MM is used much more widely for transplant patients. More complete information and recent studies should be consulted before prescribing MM.
Mechanism of Action
MM inhibits and suppresses lymphocytes. MM is an ester of mycophenolic acid and is currently used to prevent transplant rejection. It is a non-competitive inhibitor of inosine-monophosphate-dehydrogenase and thus influences the function of lymphocytes via the inhibition of purine synthesis. It reversibly blocks the synthesis of guanine nucleotides required for DNA and RNA synthesis during T and B cell proliferation.
Dosing in Dermatology
- Start 500 bid
- Commonly go to 1000 bid
- Maximum dose is 1500 bid
Common Side Effects
- GI disturbance most common.
- Persistent cough
- Is there increased risk of lymphoma, cancer???
Pregnancy Category D
MM can cause great harm to the developing fetus. MM should not be used in pregnancy.
- CellCept (mycophenolate mofetil) is indicated for the prophylaxis of solid organ rejection in adults receiving allogeneic organ
- CellCept (mycophenolate mofetil) is indicated for the prophylaxis of organ rejection in pediatric patients (2 to 18 years) receiving allogeneic renal transplants.
Baseline and routine CBC and SGPT are in order. The patient should be questioned among other things about nausea, vomiting, and any signs of infection.
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