Can mycophenolic acid dose requirement during the first transplant help predict dosing for the second transplant?

We describe the pharmacokinetic profile of mycophenolic acid (MPA) in a patient receiving Mycophenolate mofetil (MMF) during her first and second renal transplantations. The MMF dose required to achieve a therapeutic range of MPA-AUC0–12 h early following the second transplantation was 10 times grea...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2010-10, Vol.25 (10), p.3449-3452
Main Authors: Annapandian, Vellaichamy M., Basu, Gopal, Mathew, Binu S., Fleming, Denise H., Jacob, Chakko K., John, George T.
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Area Under Curve
Biological and medical sciences
Drug Monitoring
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
intra-individual variability
Kidney Transplantation
Medical sciences
mycophenolic acid
Mycophenolic Acid - administration & dosage
pharmacokinetics
renal transplantation
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
therapeutic drug monitoring
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Summary:We describe the pharmacokinetic profile of mycophenolic acid (MPA) in a patient receiving Mycophenolate mofetil (MMF) during her first and second renal transplantations. The MMF dose required to achieve a therapeutic range of MPA-AUC0–12 h early following the second transplantation was 10 times greater than that required late following the first transplantation. Her MMF requirement then declined and continued to decrease even beyond 1 year. Intra-individual variability in MPA profiles precluded the ability to predict MMF dosing for the second transplant based on that during the first. Therapeutic drug monitoring of MMF should be continued beyond 1 year of transplantation.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfq436