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QuickView for mycophenolate mofetil (compound)


PubChem
Name: mycophenolate mofetil
PubChem Compound ID: 10455632
Molecular formula: C23H31NO7
Molecular weight: 435.487 g/mol
DrugBank
Identification
Name: mycophenolate mofetil
Name (isomeric): DB00688
Drug Type: small molecule
Synonyms:
Mycophenylate mofetil
Brand: CellCept, Munoloc
Category: Antineoplastic Agents, Enzyme Inhibitors, Immunosuppressive Agents, Dermatologic Agents
CAS number: 128794-94-5
Pharmacology
Indication: For the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. Mycophenolate mofetil should be used concomitantly with cyclosporine and corticosteroids.
Pharmacology:
Mycophenolate mofetil is a prodrug of mycophenolic acid, an antibiotic substance derived from Penicillium stoloniferum. It blocks de novo biosynthesis of purine nucleotides by inhibition of the enzyme inosine monophosphate dehydrogenase. Mycophenolic acid is important because of its selective effects on the immune system. It prevents the pro...
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Mechanism of Action:
Mycophenolate mofetil is hydrolyzed to form mycophenolic acid (MPA), which is the active metabolite. MPA is a potent, selective, uncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), and therefore inhibits the de novo pathway of guanosine nucleotide synthesis without incorporation into DNA. Because T- and B-lymphoc...
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Absorption: Rapidly absorbed following oral administration. In 12 healthy volunteers, the mean absolute bioavailability of oral mycophenolate mofetil relative to intravenous mycophenolate mofetil (based on MPA AUC) was 94%. Food (27 g fat, 650 calories) has no effect on the extent of absorption (MPA AUC) of mycophenolate mofetil.
Protein binding: MPA (the active metabolite), at clinically relevant concentrations, is over 98% bound to plasma albumin.
Biotransformation: Following oral and intravenous dosing, mycophenolate mofetil undergoes complete metabolism to MPA, the active metabolite. Metabolism to MPA occurs presystemically after oral dosing. MPA is metabolized principally by glucuronyl transferase to form the phenolic glucuronide of MPA (MPAG) which is not pharmacologically active. In vivo, MPAG is converted to MPA via enterohepatic recirculation. The following metabolites of the 2-hydroxyethyl-morpholino moiety are also recovered in the urine following oral administration of mycophenolate mofetil to healthy subjects: N-(2-carboxymethyl)-morpholine, N-(2-hydroxyethyl)-morpholine, and the N-oxide of N-(2-hydroxyethyl)-morpholine.
Route of elimination: Negligible amount of drug is excreted as MPA (< 1% of dose) in the urine. Most (about 87%) of the administered dose is excreted in the urine as MPAG.
Half Life: The mean elimination half-life for mycophenolic acid (the active metabolite) ranges from 8-16 hours, while that of the MPAG metabolite ranges from 13-17 hours.
Clearance: 193 +/- 48 mL/min [following oral administration]
Toxicity: Oral (LD50): Acute: 352 mg/kg [Rat], 1000 mg/kg [Mouse], and >6000 mg/kg [Rabbit]. Possible signs and symptoms of acute overdose could include the following: hematological abnormalities such as leukopenia and neutropenia, and gastrointestinal symptoms such as abdominal pain, diarrhea, nausea and vomiting, and dyspepsia.
Affected organisms: Humans and other mammals
Interactions
Food interaction:
Do not take calcium, aluminium, magnesium or iron supplements within 2 hours of taking this medication.
Take on empty stomach: 1 hour before or 2 hours after meals.
Drug interaction:
TrastuzumabTrastuzumab may increase the risk of neutropenia and anemia. Monitor closely for signs and symptoms of adverse events.
Iron DextranOral iron decreases the absorption of mycophenolate-mofetil
TacrolimusTacrolimus may increase the plasma concentration of Mycophenolic acid. Monitor and adjust the dose of Mycophenolate mofetil to the therapeutic range.
CalciumFormation of non-absorbable complexes
ValganciclovirThe excretion rates of Valganciclovir and/or Mycophenolate mofetil may decrease. Monitor for increased serum concentrations and toxicity of both agents.
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Targets


Enzymes