Mycophenolate mofetil

Chemical properties

White or almost white, crystalline powder.

The Uses of Mycophenolate mofetil

Mycophenolate Mofetil is an intermediate in the synthesis of (4Z)-Mycophenolate Mofetil (M831455), a degradation product of Mycophenolate mofetil, an immunosuppressant.

The Uses of Mycophenolate mofetil

Inhibitor of nucleic acid synthesis; immunomodulator.

Indications

Mycophenolate mofetil (CellCept), in conjunction with cyclosporine and corticosteroids, has clinical applications in the prevention of organ rejection in patients receiving allogeneic renal and cardiac transplants. By effectively inhibiting de novo purine synthesis, it can impair the proliferation of both T and B lymphocytes. Following oral administration, mycophenolate mofetil is almost completely absorbed from the GI tract, metabolized in the liver first to the active compound mycophenolic acid, and then further metabolized to an inactive glucuronide.
Early clinical trials indicate that mycophenolate mofetil in conjunction with cyclosporine and corticosteroids is a more effective regimen than azathioprine in preventing the acute rejection of transplanted organs. GI side effects are most common.

Definition

ChEBI: Mycophenolate mofetil is a carboxylic ester resulting from the formal condensation between the carboxylic acid group of mycophenolic acid and the hydroxy group of 2-(morpholin-4-yl)ethanol. In the liver, it is metabolised to mycophenolic acid, an immunosuppressant for which it is a prodrug. It is widely used to prevent tissue rejection following organ transplants as well as for the treatment of certain autoimmune diseases. It has a role as an immunosuppressive agent, a prodrug, an EC 1.1.1.205 (IMP dehydrogenase) inhibitor and an anticoronaviral agent. It is a gamma-lactone, a member of phenols, an ether, a carboxylic ester and a tertiary amino compound. It is functionally related to a mycophenolic acid and a 2-(morpholin-4-yl)ethanol.

brand name

Cellcept (Roche).

Side Effects

The main side effects include an increased incidence of herpes zoster, neutropenia, gastrointestinal symptoms, and opportunistic infections. In the transplant literature, 1% to 2% of patients will develop a lymphoproliferative malignancy at the doses recommended for psoriasis. This is a teratogen and should be avoided in women of childbearing age.