Pharmacokinetics and Pharmacodynamics of Mycophenolate in Patients After Renal Transplantation

Mycophenolic-acid (MPA) is a selective, non-competitive inhibitor of InosineMonophosphate-Dyhydrogenase (IMPDH) leading to the inhibition of the de-novo synthesis of guanosine-nucleotides. In human lymphocytes inhibition of IMPDH results in altered cellular proliferation with arrest in the S-phase of the cell cycle. Due to the absence of a salvage pathway, proliferating activated t-cells are severely affected by the inhibitory effects of MPA (1-3). For patients after renal transplantation MPA is used either as mycophenolate-mofetil (MMF, Cellcept) or as enteric-coated mycophenolate-Sodium (ECMPS, Myfortic) in daily doses of 2000 mg respectively 1440 mg per day.