Mycophenolic acid (MPA), sold under the brand name Myfortic, is a prescription medication used to prevent the rejection of organ transplants in adult patients and children aged 5 years or older. It belongs to the class of drugs known as immunosuppressants. Mycophenolic acid works by suppressing the body’s immune system after an artificial organ transplant.
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What Is Myfortic (Mycophenolic Acid)?
Mycophenolic acid is an immunosuppressant medication. It is commonly given in combination with other drugs, such as corticosteroids or cyclosporine, as a prophylactic treatment to prevent organ transplant rejections by the immune system.
Before an organ transplant or prior to taking mycophenolic acid, it is crucial to inform your doctor and pharmacist if you are using any over-the-counter or prescription medicines, herbal products, or vitamins.
Mycophenolic acid should not be used during pregnancy as it increases the risk of birth defects and pregnancy loss.
How Is Mycophenolic Acid Given?
- Mycophenolic acid is given orally or injected into a vein. The drug should not be given by rapid IV injection or bolus-administered.
- Mycophenolic acid should be taken on an empty stomach, 1 hour before or 2 hours after having food.
- The drug should be used in combination with corticosteroids and/or cyclosporine.
- Mycophenolic acid is commonly given two times a day.
- The mycophenolic acid tablets should be swallowed as a whole. Do not crush, cut, or chew the tablet.
- Mycophenolic acid is administered to children aged 5 years and older to prevent organ transplant rejections.
What Is It Used To Treat?
Mycophenolic acid is used to treat certain autoimmune conditions, like lupus and Crohn’s disease, and prevent organ rejection in patients receiving an artificial:
- Kidney transplant
- Liver transplant
- Heart transplant
How Does Mycophenolic Acid Work?
Mycophenolic acid is a metabolite of mycophenolate mofetil and a reversible inhibitor of the enzyme inosine-5′-monophosphate dehydrogenase.
The drug inhibits the proliferation (growth) of T and B lymphocytes, the white blood cells of our immune system responsible for causing immune responses to foreign substances. This effect leads to the suppression of immune response to artificial organ transplants.
Mycophenolic acid depletes guanosine nucleotides in the T and B lymphocytes, hence suppressing antibody formation and cell-mediated immune response.
Side Effects Of Mycophenolic Acid
The common side effects of mycophenolic acid include:
- Nausea and vomiting
- Indigestion
- Constipation
- Diarrhea
- Sleep disturbances
- Low blood cell count
- Weight loss
The common side effects of mycophenolic acid go away with time as the body gets used to the drug or when the therapy is completed. But if the side effects persist or become severe or intolerable, consult your doctor or pharmacist.
The rare or severe side effects of mycophenolic acid include:
- Swelling of face, lips, throat, or tongue
- Difficulty breathing
- Swollen glands
- Fever
- Painful mouth sores
- Unusual bleeding or bruising
- Vomiting or coughing with blood
- Stomach pain
- Blood in stools
The common adverse reactions of mycophenolic acid include:
- Anemia
- Urinary tract infection
- Leukopenia
- Postoperative pain
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Strength And Dosage Forms Of Mycophenolic Acid
Mycophenolic acid comes in tablets, capsules, oral suspensions, and powder for injection. The powder for injection is reconstituted to a liquid form and injected into the vein.
Mycophenolic acid is available in the following strengths:
Capsule
- 250 mg
Tablet
- 500 mg
Oral suspension
- 200 mg/ml
Powder for injection
- 180 mg
- 360 mg
Mycophenolic Acid Dose
The usual oral adult dose of mycophenolic acid for organ transplant rejection is 720 mg orally two times daily. Dose adjustments for renal or kidney impairment are not needed.
For Kidney Transplant
The intravenous dose of mycophenolic acid for a kidney transplant is 1 g IV every 12 hours, infused over 2 hours.
For Heart Transplant
The intravenous dose of mycophenolic acid for a heart transplant is 1.5 g IV every 12 hours infused over 2 hours.
For Liver Transplant
The intravenous dose of mycophenolic acid for a liver transplant is 1 g IV every 12 hours, infused over 2 hours.
Pediatric Dose:
- For children aged 5 years and older, the dose of mycophenolic acid is 400 mg/m2 orally two times a day. The maximum dose is 720 mg two times a day.
- The dose of pediatrics with a BSA of 1.19-1.58 m2 is three 180 mg tablets or one 180 mg tablet with one 360 mg tablet twice daily.
- For pediatrics with a BSA above 1.58 m2, the dose of mycophenolic acid is four 180 mg tablets or two 360 mg tablets two times daily.
Interactions Of Mycophenolic Acid
Mycophenolic acid may interact with the following medications:
- Cholestyramine
- Azathioprine
- Antiviral medications, such as acyclovir or ganciclovir.
Price
The cost of mycophenolic acid depends on several factors, including:
- The type of pharmacy you visit.
- The number of doses prescribed.
- The health condition or severity of the disease of the patient.
On average, the price of oral mycophenolic acid delayed-release tablets is approximately $38 for 20 tablets.
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FAQs
What is mycophenolic acid used for?
Mycophenolic acid, also known as Myfortic, is an immunosuppressant medication used to prevent the rejection of organ transplants, like artificial transplants of the kidney, heart, or liver. It is given in combination with corticosteroids or cyclosporine. The drug is mainly given to prevent the rejection of kidney transplants in children and adults.
Is mycophenolic acid an antibiotic?
Yes. Mycophenolic acid is an immunosuppressant agent and was rediscovered as an antibiotic. It was produced from Penicillium brevicompactum, P. echinulatum, P. stoloniferum, and related species. Mycophenolic acid has been shown to have antibacterial, antiviral, and antifungal properties.
Is mycophenolic acid toxic?
There are some reported adverse effects of mycophenolic acid. For example, it may cause pure red cell aplasia (PRCA), a severe anemic condition. Exposure to mycophenolic acid can also increase the risks of opportunistic infections, such as Candida and clostridia.
Taking the drug according to your doctor’s recommendation with continuous monitoring for adverse effects can reduce the chances of potential toxicity or adverse effects associated with mycophenolic acid.
Conclusion
Mycophenolic acid is an immunosuppressant prescription-based medication given to prevent the rejection of organ transplants by the immune system in adults and children aged 5 years and older. It comes in tablet and injectable dosage forms and is commonly given twice daily in combination with corticosteroids or cyclosporine. Mycophenolic acid should not be taken during pregnancy.
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Dr. Mark Alfonso, PharmD was born and raised in Pueblo, CO. He received his pharmacy degree from the University of Colorado School of Pharmacy at the Anschutz Medical Campus in 2010. He was board certified in medication therapy management in 2022. The most rewarding part of his job is helping to answer patient questions and concerns. His areas of expertise are community pharmacy and medication therapy management. In his free time, he enjoys reading and running.