Comparative Pharmacology
Head-to-head clinical analysis: MYCOPHENOLATE MOFETIL versus MYFORTIC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MYCOPHENOLATE MOFETIL versus MYFORTIC.
MYCOPHENOLATE MOFETIL vs MYFORTIC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Mycophenolic acid inhibits inosine monophosphate dehydrogenase (IMPDH), thereby depleting guanosine nucleotides in T and B lymphocytes, suppressing their proliferation and antibody production.
1 g orally twice daily; intravenous infusion 1 g over 2 hours twice daily for up to 14 days.
720 mg orally twice daily, on an empty stomach, 1 hour before or 2 hours after meals.
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
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.
Terminal elimination half-life is approximately 12-18 hours (mean 17 hours) in healthy volunteers; longer in hepatic impairment (up to 40 hours).
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.
Primarily renal (approximately 95% as metabolites, <3% as unchanged drug); biliary/fecal excretion accounts for <5%.
Category D/X
Category C
Immunosuppressant
Immunosuppressant
"Mycophenolate mofetil may decrease the cardiotoxic activities of Ouabain."