Pharmacokinetics of mycophenolic acid in children with clinically stable idiopathic nephrotic syndrome receiving cyclosporine

Background The suitable dosage regime of mycophenolate mofetil (MMF) based on the pharmacokinetics of mycophenoric acid (MPA) for pediatric patients with idiopathic nephrotic syndrome (INS) is controversial. The pharmacokinetics of MPA is influenced by renal function, serum albumin concentration, an...

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Bibliographic Details
Published in:Clinical and experimental nephrology 2017-02, Vol.21 (1), p.152-158
Main Authors: Hibino, Satoshi, Nagai, Takuhito, Yamakawa, Satoshi, Ito, Hidekazu, Tanaka, Kazuki, Uemura, Osamu
Format: Article
Language:English
Subjects:
Adolescent
Age Factors
Area Under Curve
Calcineurin Inhibitors - administration & dosage
Child
Child, Preschool
Cyclosporine - administration & dosage
Drug Dosage Calculations
Drug Therapy, Combination
Female
Humans
Immunosuppressive Agents - administration & dosage
Immunosuppressive Agents - blood
Immunosuppressive Agents - pharmacokinetics
Male
Medicine
Medicine & Public Health
Mycophenolic Acid - administration & dosage
Mycophenolic Acid - blood
Mycophenolic Acid - pharmacokinetics
Nephrology
Nephrotic Syndrome - blood
Nephrotic Syndrome - diagnosis
Nephrotic Syndrome - drug therapy
Original Article
Retrospective Studies
Treatment Outcome
Urology
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Summary:Background The suitable dosage regime of mycophenolate mofetil (MMF) based on the pharmacokinetics of mycophenoric acid (MPA) for pediatric patients with idiopathic nephrotic syndrome (INS) is controversial. The pharmacokinetics of MPA is influenced by renal function, serum albumin concentration, and concomitant medications, especially calcineurin inhibitors. This study analyzed the pharmacokinetics of MPA in clinically stable children with INS receiving cyclosporine (CyA). Methods This retrospective study enrolled children with INS receiving MMF (Cellcept ® ) (30–40 mg/kg/day in two divided doses) combined with CyA (Neoral ® ) without relapse and renal dysfunction. Pharmacokinetic parameters, including the area under the concentration–time curve (AUC) calculated by the trapezoid method, were calculated from seven serial blood samples. Results Thirty-two patients (22 males) of median age 11.0 years were included; 32 pharmacokinetic studies were performed. The median MMF dose was 16.2 mg/kg/time or 470.4 mg/m 2 /time. The median AUC0–12 was 44.3 ng h/mL. AUC0–12 of all patients showed excellent correlations with C2 ( r 2  = 0.6405, P  
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-016-1267-7