Comparative Pharmacology
Head-to-head clinical analysis: CEQUA versus MYCOPHENOLATE MOFETIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CEQUA versus MYCOPHENOLATE MOFETIL.
CEQUA vs MYCOPHENOLATE MOFETIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Immunosuppressant; binds to cyclophilin D in mitochondria, inhibiting opening of mitochondrial permeability transition pore (mPTP), which reduces T-lymphocyte activation and cytokine release. Also forms complex with cyclophilin A to inhibit calcineurin, suppressing IL-2 production and T-cell proliferation.
Mycophenolate mofetil is a prodrug that is rapidly hydrolyzed to mycophenolic acid (MPA), a potent, selective, uncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), which inhibits the de novo pathway of guanosine nucleotide synthesis. This inhibition preferentially blocks proliferation of T- and B-lymphocytes, as they are critically dependent on this pathway, thereby suppressing cell-mediated immune responses and antibody formation.
Instill one drop of 0.09% ophthalmic solution in each eye twice daily, approximately 12 hours apart.
1 g orally twice daily; intravenous infusion 1 g over 2 hours twice daily for up to 14 days.
None Documented
None Documented
Clinical Note
moderateMycophenolate mofetil + Digitoxin
"Mycophenolate mofetil may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateMycophenolate mofetil + Deslanoside
"Mycophenolate mofetil may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateMycophenolate mofetil + Acetyldigitoxin
"Mycophenolate mofetil may decrease the cardiotoxic activities of Acetyldigitoxin."
Clinical Note
moderateMycophenolate mofetil + Ouabain
Terminal elimination half-life is approximately 8.4 hours (range 6-10 hours) in healthy adults; prolonged in hepatic impairment and pediatric patients.
The terminal elimination half-life of mycophenolic acid (MPA) is approximately 8-16 hours in healthy volunteers and renal transplant patients. In patients with renal impairment, the half-life may be prolonged due to accumulation of MPAG. The half-life supports twice-daily dosing.
Primarily fecal (90%) with minor renal excretion (<1% unchanged drug). Biliary excretion is the major route for elimination of cyclosporine metabolites.
Mycophenolate mofetil is extensively metabolized to mycophenolic acid (MPA), which is primarily eliminated in urine as MPA glucuronide (MPAG). Approximately 87% of the dose is excreted in urine as MPAG, with less than 1% as unchanged MPA. Fecal excretion accounts for about 6% of the dose, mainly as MPAG. Biliary excretion contributes to enterohepatic recirculation of MPA, enhancing its exposure.
Category C
Category D/X
Immunosuppressant
Immunosuppressant
"Mycophenolate mofetil may decrease the cardiotoxic activities of Ouabain."