Mycophenolate mofetil

Immunosuppressive agent, ester of mycophenolic acid, a mycotoxin.

Specific, non-competitive, reversible inhibitor of inosine monophosphate dehydrogenase, which is a key enzyme of guanosine nucleotide synthesis in T and B lymphocytes.

Antiproliferative effect on lymphocytes and immunosuppressive effect by inhibiting antibody formation. Inhibition of mitogen- or antigen-stimulated proliferation of B and T lymphocytes, antigen-induced production of antibodies by B lymphocytes, mast cell degranulation, and lipoxygenase. The influence on cytokine production is still unclear.

• Psoriasis: Initial 2 times/day 1 g p.o. for 3 weeks, then 2 times/day 0.5 g p.o. for 3 weeks.
• Psoriasis arthropathica: combination with low-dose acitretin (0.1-0.2 mg/kg bw/day p.o.)
• Bullous pemphigoid: 1.0 g/2 times/day p.o. in combination with prednisolone 2 mg/kg bw/day p.o. Subsequently reduction of glucocorticoid.
• Pemphigus vulgaris: 1,0 g/2 times/day p.o. in combination with prednisolone 2 mg/kg bw/day p.o. Followed by reduction of the glucocorticoid.
• Systemic vasculitis and systemic lupus erythematosus: 1.0 g/2 times/day p.o. in combination with prednisolone.
• Pyoderma gangraenosum: If necessary, combination of mycophenolate mofetil 1.0 g/2 times/day p.o., Ciclosporin A 50-100 mg/day total dose and prednisolone.
• Pfeifer-Weber-Christian-Syndrome: In severe cases and poor response to therapy with prednisolone/azathioprine or methotrexate. 1.0 g/2 times/day p.o. Mycophenolate mofetil in combination with prednisolone 2.0 mg/kg bw/day.
• Dyshidrotic eczema: initial 1.5 g/2 times/day, after 4 weeks 1.0 g/2 times/day p.o.
• Dermatomyositis: 1.0 g/2 times/day p.o. Mycophenolate mofetil in combination with prednisolone.

Notice! In women of childbearing age, pregnancy must be ruled out before therapy and effective contraception must be used during therapy!

1. Baskan EB et al (2003) Effective treatment of relapsing idiopathic nodular panniculitis (Pfeifer-Weber-Christian disease) with mycophenolate mofetil. J Dermatolog Treat 14: 57-60
2. Daudén E et al (2004) Plasma trough levels of mycophenolic acid do not correlate with efficacy and safety of mycophenolate mofetil in psoriasis. Br J Dermatol 150: 132-135
3. Geilen CC et al (2000) Mycophenolate mofetil: a new immunosuppressive drug in dermatology and its possible uses. dermatologist 51: 63-69
4. Michel S et al (1999) Therapy-resistant pyoderma gangrenosum--treatment with mycophenolate mofetil and cyclosporine A. Dermatologist 50: 428-431
5. Mimouni D et al (2003) Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil. Arch Dermatol 139: 739-742
6. Moder KG et al (2003) Mycophenolate mofetil: new applications for this immunosuppressant. Ann Allergy Asthma Immunol 90: 15-19
7. Powell AM et al (2003) An evaluation of the usefulness of mycophenolate mofetil in pemphigus. Br J Dermatol 149: 138-145
8. Reynaert S et al (2003) Successful treatment of two patients with pyoderma gangraenosum using mycophenolate mofetil. Br J Dermatol 149(Suppl 64): 25
9. Trebing D et al (2001) Acquired epidermolysis bullosa with a highly varied clinical picture and successful treatment with mycophenolate mofetil. dermatologist 52: 717-721

Possible side effects of Mycophenolatmofetil