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Mr. Ibrahem/Mycophenolic acid
Clinical data
Pronunciation /ˌmaɪkoʊfɪˈnɒlɪk/
Trade namesCellCept, Myfortic, others
Other namesMycophenolate sodium, mycophenolate mofetil
AHFS/ Drugs.com Monograph
MedlinePlus a601081
License data
Pregnancy
category
Routes of
administration		By mouth, intravenous [2]
Legal status
Legal status
  • AU: S4 (Prescription only)
  • CA: ℞-only
  • UK: POM (Prescription only)
  • US: ℞-only
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability72% (sodium),
94% (mofetil) [3]
Protein binding82–97% [3]
MetabolismLiver [3]
Elimination half-life17.9±6.5 hours [3]
ExcretionUrine (93%),
faeces (6%) [3]
Identifiers
  • (4E)-6-(4-Hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydro-2-benzofuran-5-yl)-4-methylhex-4-enoic acid
Chemical and physical data
FormulaC17H20O6
Molar mass320.341 g·mol−1
3D model ( JSmol)
  • O=C1OCc2c1c(O)c(c(OC)c2C)C\C=C(/C)CCC(=O)O
  • InChI=1S/C17H20O6/c1-9(5-7-13(18)19)4-6-11-15(20)14-12(8-23-17(14)21)10(2)16(11)22-3/h4,20H,5-8H2,1-3H3,(H,18,19)/b9-4+ checkY
  • Key:HPNSFSBZBAHARI-RUDMXATFSA-N checkY
 ☒NcheckY  (what is this?)   (verify)

Mycophenolic acid (MPA), and also called mycophenolate, is an immunosuppressant medication used to prevent rejection following organ transplantation and to treat Crohn's disease, SLE, interstitial lung disease, and scleroderma. [6] [4] Specifically it is used following kidney, heart, and liver transplantation. [4] It can be given by mouth or by injection into a vein. [4] It comes as mycophenolate sodium and mycophenolate mofetil (MMF). [4]

Common side effects include nausea, infections, and diarrhea. [4] Other serious side effects include an increased risk of cancer, progressive multifocal leukoencephalopathy, anemia, and gastrointestinal bleeding. [4] Use during pregnancy may harm the baby. [4] Effects when taken by the father is unclear. [7] Mycophenolic acid is in the disease-modifying antirheumatic drugs (DMARDs) family of medications. [6] It works by blocking inosine monophosphate dehydrogenase (IMPDH), which is needed by lymphocytes to make guanosine. [4]

Mycophenolic acid was initially discovered by Italian Bartolomeo Gosio in 1893. [8] [9] It was rediscovered in 1945 and 1968. [9] It was approved for medical use in the United States in 1995 following the discovery of its immunosuppressive properties in the 1990s. [4] [8] It is available as a generic medication. [7] In the United Kingdom MMF at a dose of 1.5 gram twice daily costs the NHS about £25 per month as of 2021. [7] In the United States this amount is about US$114. [10] In 2017, it was the 254th most commonly prescribed medication in the United States, with more than one million prescriptions. [11] [12]

References

  1. ^ a b "Mycophenolate mofetil (CellCept) Use During Pregnancy". Drugs.com. 24 January 2020. Retrieved 6 April 2020.
  2. ^ Jasek W, ed. (2007). Austria-Codex (in German) (62nd ed.). Vienna: Österreichischer Apothekerverlag. pp. 1484–95. ISBN  978-3-85200-181-4.
  3. ^ a b c d e "CellCept" (PDF). TGA eBusiness Services. Roche Products Pty Limited. 13 December 2012. Retrieved 25 February 2014.
  4. ^ a b c d e f g h i j k "Mycophenolate Monograph for Professionals". Drugs.com. Retrieved 28 October 2019.
  5. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Retrieved 5 September 2020.
  6. ^ a b Shagroni, T.; Cazares, Ramirez; Kim, J. A.; Furst, Daniel E. (2020). "36. Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, nonopioid analgesics, & drugs used in gout". In Katzung, Bertram G.; Trevor, Anthony J. (eds.). Basic and Clinical Pharmacology (15th ed.). New York: McGraw-Hill. p. 678. ISBN  978-1-260-45231-0.
  7. ^ a b c "8. Immune system and malignant disease". British National Formulary (BNF) (82 ed.). London: BMJ Group and the Pharmaceutical Press. September 2021 – March 2022. pp. 895–897. ISBN  978-0-85711-413-6.{{ cite book}}: CS1 maint: date format ( link)
  8. ^ a b Schiff, Eugene R.; Maddrey, Willis C.; Sorrell, Michael F. (2011). Schiff's Diseases of the Liver. John Wiley & Sons. p. PT3219. ISBN  978-1-119-95048-6.
  9. ^ a b Laskin, Allen I.; Bennett, Joan W.; Gadd, Geoffrey M. (2001). Advances in Applied Microbiology. Gulf Professional Publishing. p. 236. ISBN  978-0-12-002648-7.
  10. ^ "Mycophenolate mofetil Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 29 October 2019.
  11. ^ "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.
  12. ^ "Mycophenolate Mofetil - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.
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