MMF
Generic Name
Mycophenolate Mofetil
Manufacturer
Various Generic Manufacturers
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| mmf 500 mg tablet | ৳ 65.00 | ৳ 650.00 |
Description
Overview of the medicine
Mycophenolate Mofetil (MMF) is an immunosuppressant medicine used to prevent the body from rejecting a transplanted organ (e.g., kidney, heart, liver). It works by weakening the body's immune system.
Uses & Indications
Dosage
Adults
Renal transplant: 1 g (two 500 mg tablets) orally twice daily (2 g daily). Cardiac transplant: 1.5 g (three 500 mg tablets) orally twice daily (3 g daily). Hepatic transplant: 1 g (two 500 mg tablets) orally twice daily (2 g daily). Initial dose usually within 24 hours of transplantation.
Elderly
No specific dose adjustment is generally required for elderly patients, but careful monitoring for adverse effects is recommended.
Renal_impairment
For severe chronic renal impairment (glomerular filtration rate <25 mL/min/1.73 m²), avoid doses exceeding 1 g twice daily for renal transplant patients. These patients should be carefully monitored.
How to Take
MMF tablets should be swallowed whole with water on an empty stomach (one hour before or two hours after food) to improve absorption. Do not crush or chew the tablets. Administer twice daily.
Mechanism of Action
Mycophenolate mofetil is metabolized to mycophenolic acid (MPA), a potent, selective, noncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). This inhibits de novo purine synthesis, thereby inhibiting the proliferation of B and T lymphocytes, which are critical in the immune response.
Pharmacokinetics
Onset
Immunosuppressive effects begin within hours, but clinical benefits are observed with long-term use.
Excretion
MPAG is primarily excreted via urine. A small amount of MPA is excreted in bile.
Half life
The elimination half-life of mycophenolic acid (MPA) is approximately 11-17 hours.
Absorption
Rapid and extensive absorption after oral administration, but subject to significant first-pass metabolism. Bioavailability is approximately 70-90%. Peak plasma concentration (Cmax) occurs 1-2 hours post-dose.
Metabolism
Primarily hepatic, converted to its active metabolite mycophenolic acid (MPA), then extensively metabolized via glucuronidation to mycophenolic acid glucuronide (MPAG). Undergoes enterohepatic recirculation.
Side Effects
Contraindications
- Hypersensitivity to mycophenolate mofetil, mycophenolic acid, or any component of the formulation.
- Pregnancy, due to the high risk of teratogenicity and fetal harm.
- Women of childbearing potential not using effective contraception.
Drug Interactions
Cholestyramine
Significantly reduces MPA exposure by interfering with enterohepatic recirculation.
Oral contraceptives
May decrease the efficacy of oral contraceptives; additional contraception methods are recommended.
Acyclovir, Ganciclovir
May increase plasma concentrations of both MMF and the antiviral drug due to competition for tubular secretion.
Proton pump inhibitors (PPIs)
May reduce MPA exposure; monitor patients.
Antacids (containing magnesium and aluminum hydroxide)
Reduced absorption of MMF; separate administration by at least 2 hours.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
Overdose may lead to increased immunosuppression and an increased susceptibility to infection. Gastric lavage and symptomatic treatment are recommended. Hemodialysis is not effective in removing MPA. Cholestyramine can remove MPA by interrupting enterohepatic recirculation.
Pregnancy & Lactation
Mycophenolate Mofetil is highly teratogenic and contraindicated in pregnancy due to a high risk of birth defects and miscarriage. Women of childbearing potential must use two reliable forms of contraception during treatment and for 6 weeks after stopping. Breastfeeding is contraindicated due to potential serious adverse reactions in the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, specific to manufacturer.
Availability
Pharmacies, Hospitals
Approval Status
Approved (Globally and by DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of mycophenolate mofetil in preventing organ rejection following renal, cardiac, and hepatic transplantation. Ongoing research continues to explore its use in other autoimmune conditions and transplant settings.
Lab Monitoring
- Complete Blood Count (CBC) with differential, weekly for the first month, twice monthly for the second and third months, then monthly for the first year.
- Liver Function Tests (LFTs) periodically.
- Renal Function Tests (serum creatinine, BUN) periodically.
- Blood pressure monitoring.
- Plasma Mycophenolic Acid (MPA) levels (Therapeutic Drug Monitoring) may be used in specific situations.
Doctor Notes
- Crucial for patient counseling on infection risk, sun protection, and the absolute necessity of effective contraception.
- Regular monitoring of CBC, LFTs, and renal function is paramount, especially during the initial months of therapy.
- Consider therapeutic drug monitoring (TDM) in specific patient populations (e.g., severe renal impairment, gastrointestinal issues, or suspected non-compliance).
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not crush, chew, or break the tablets; swallow them whole.
- Take on an empty stomach for better absorption (one hour before or two hours after food).
- Use two reliable forms of contraception during treatment and for 6 weeks after stopping if you are a woman of childbearing potential.
- Report any signs of infection (fever, chills, sore throat), unusual bleeding or bruising, or persistent gastrointestinal problems to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for the next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Mycophenolate mofetil may cause dizziness, tremors, or somnolence. Patients should be cautious when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Avoid prolonged exposure to sunlight and UV light due to an increased risk of skin cancer; use protective clothing and broad-spectrum sunscreen.
- Practice good hand hygiene to minimize the risk of infection.
- Avoid live vaccines during treatment.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.