ミコフェノール酸モフェチル

使用用途

• IMHA
• Immune-mediated hemolytic anemia (IMHA)
• IMHA, myasthenia gravis or glomerulonephritis
• Immune-mediated hemolytic anemia (IMHA)
• Adjunctive treatment of glomerulonephritis
• Pemphigus foliaceous
• Pemphigus foliaceous
• Aplastic anemia
• Rescue agent for generalized myasthenia gravis

投与方法

考えられる副作用

• Diarrhea (can be severe)
• Vomiting
• Anorexia
• Lethargy / reduced activity
• Weight loss
• Lymphopenia
• Increased rates of dermal infections
• Increased susceptibility to systemic infections
• Potential increased risk of malignancy/lymphoma
• Bone marrow suppression
• Nausea
• Diarrhoea
• Increased incidence of infections (e.g., pyoderma, Malassezia)
• Increased risk of lymphoma (reported in humans)

注意事項と禁忌

• Documented hypersensitivity to mycophenolate
• Pregnancy (teratogenic effects noted in animal models)
• Caution in patients with severe renal dysfunction (dosage adjustment may be required)
• Caution in cats (deficient in glucuronidation metabolism)
• Pre-existing bone marrow suppression
• Pre-existing infections
• > **Black Box Warning:** In humans, mycophenolate carries a warning regarding a potential increased risk for lymphoma and susceptibility to infections associated with its use. * **Intravenous Administration:** Must be administered over at least two hours. **Do NOT give as an IV bolus or via rapid IV infusion.** * **Feline Patients:** The active metabolite (MPA) is primarily excreted as a glucuronide metabolite. Cats are deficient in this metabolic process; use with extreme caution. * **Pregnancy:** Teratogenic (increased resorptions and malformations). Avoid use during pregnancy. * **Handling:** Due to teratogenic risks, tablets or capsules should not be crushed, split, or opened. Personnel and owners should wear gloves when handling.

薬物相互作用

• Acyclovir: Increased serum concentrations of acyclovir and the phenolic glucuronide of mycophenolic acid
• Antacids (aluminum or magnesium containing): Decreased absorption of mycophenolate; separate dosing by at least 2 hours
• Aspirin (or other salicylates): Potentially increased concentrations of free mycophenolic acid
• Azathioprine: Increased risk for bone marrow suppression; use together not recommended in humans
• Iron (oral): Decreased absorption of mycophenolate; separate dosing by at least 2 hours
• Probenecid: Potentially increased serum levels of mycophenolic acid and the phenolic glucuronide of mycophenolic acid
• Vaccines (live virus): May be less effective; avoid use
• Drugs undergoing active renal tubular secretion: Competes for secretion, resulting in increased concentrations of either drug
• Antacids (e.g., omeprazole): Concomitant administration may decrease the absorption of mycophenolate

よくある質問