MYCOPHENOLIC ACID AND METABOLITES
- MYCOPHENOLIC ACID AND METABOLITES
- Start Date
- Expiration Date
- Cellcept™, CellCept™ MPA, Mofetil Ester, Mycophenolate, Mycophenolate Mofetil, Myfortic™, Prodrug
- CPT Codes
- Reference Test
- ATLAS Test Code
- Transport Info
Centrifuge and immediately transfer serum to separate plastic tube Refrigerated
- Fasting Required?
- Patient Instructions
- Reference Range
No therapeutic range has been established for MPA. Dosing of 2 grams per day gives trough concentrations of 1.0 - 3.5 µg/mL. At 3 grams per day dosing, the range extends to 5.0 µg/mL. Trough concentrations between 2.0 and 4.0 µg/mL appear to maximize efficacy and minimize adverse effects.
Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Mycophenolate mofetil (CellCeptTM, MMF) was approved in the United States in 1995 and in Europe in 1996 for prophylaxis of organ rejection in patients receiving allogeneic renal transplants. Physicians working with organ transplantation have begun using therapeutic monitoring of the major active metabolite (mycophenolic acid or MPA) as a tool in the management of transplant patients. After oral administration, MMF is rapidly and completely absorbed, after which the pro-drug is essentially converted to MPA. MPA interferes with the proliferation of T- and B-lymphocytes by inhibiting a key enzyme in the de novo synthesis of guanosine nucleotide, thus preventing the synthesis of DNA. This prevention consequently suppresses these elements of the immune system and reduces the prospect of transplant rejection. It is recommended that MMF be administered along with cyclosporine or a corticosteroid like prednisone or prednisolone. MMF is also useful in patients who do not tolerate cyclosporine or tacrolimus as the main immunosuppressant drug. MPA is primarily metabolized to the glucuronide (MPAG), which does not have immunosuppressant properties. More than 90 percent of the dose is eliminated in the urine as MPAG. The plasma half-life of MPA after oral administration is ca. 18 hr (± 6 hr); the half-life is extended in renal impairment.