Mycophenolate mofetil pharmacokinetics in transplant patients receiving cyclosporine or tacrolimus in combination therapy

• Published in: Pharmacology & toxicology Vol. 87; no. 4; pp. 182 - 184
• Main Authors: VIDAL, Elena, CANTARELL, Carmen, CAPDEVILA, Luis, MONFORTE, Victor, ROMAN, Antonio, POU, Leonor
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell 01-10-2000
• Subjects: Adult; Aged; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Cyclosporine - pharmacology; Dose-Response Relationship, Drug; Drug Interactions; Drug Therapy, Combination; Female; Humans; Immunosuppressive Agents - blood; Immunosuppressive Agents - pharmacokinetics; Kidney Transplantation; Lung Transplantation; Male; Medical sciences; Middle Aged; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - blood; Mycophenolic Acid - pharmacokinetics; Pharmacology. Drug treatments; Retrospective Studies; Tacrolimus - pharmacology; Human; Drug combination; Mycophenolic acid; Metabolite; Transplantation; Metabolism; Blood plasma; Chemotherapy; Treatment; Tacrolimus; Ciclosporin; Immunosuppressive agent; Pharmacokinetics
• ISSN: 0901-9928; 1600-0773
• DOI: 10.1034/j.1600-0773.2000.d01-71.x

Mycophenolate mofetil is a highly effective immunosuppressant drug used in the prophylaxis of organ rejection in combination with cyclosporine or tacrolimus and corticosteroids. The present study is a retrospective data analysis of the routinely estimated mycophenolic acid plasma trough levels in 60 transplant patients (kidney, n = 49; lung, n = 11) receiving mycophenolate mofetil in combination with prednisone and cyclosporine (n = 45) or tacrolimus (n = 15). Coadministration of cyclosporine instead of tacrolimus resulted in a significant increase of median (range) of the ratio of dose-to-concentration 0.92 (0.11-8.33) (n=167) versus 0.38 (0.11-14.28) (n = 66); P < 0.0001. No correlation was seen between mycophenolate mofetil dose and mycophenolic acid trough concentrations. The dose-to-concentration in cyclosporine-treated patients increased significantly (P<0.0001) as the cyclosporine level increased, suggesting a possible interaction between mycophenolate mofetil and cyclosporine. No correlation was seen between dose-to-concentration and tacrolimus blood levels (P x 0.215). Further studies are necessary to investigate this issue.