2012Experimental and Clinical TransplantationRequires access

Mycophenolic Acid Pharmacokinetics Early After Kidney Transplant

Nazanin Honarbakhsh, Mohammad Reza Rouini, Mahboob Lesanpezeshki, Mohammad Reza Javadi, Iman Karimzadeh, Niayesh Mohebbi, Kheirollah Gholami

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Abstract

OBJECTIVES: To determine the mycophenolic acid pharmacokinetic profile early after transplant in Iranian kidney graft recipients. MATERIALS AND METHODS: A cross-sectional study was performed during 6 months in 31 patients who recently had kidney transplant and received fixed doses of mycophenolate mofetil (2 g/d). The plasma levels of mycophenolic acid were determined by high performance liquid chromatography. RESULTS: The mean first mycophenolic acid peak level was 10 ± 5 mg/L. The mean mycophenolic acid area under the curve was 26 ± 19 mgh/L and apparent clearance was 57 ± 55 L/h. The mycophenolic acid area under the curve values of only 8 patients (26%) were within the therapeutic range (30-60 mgh/L). The first, second, and third mycophenolic acid peak levels correlated significantly with mycophenolic acid area under the curve (P < .05). Mycophenolic acid concentration at 10 hours had the highest correlation with mycophenolic acid area under the curve (r=0.962; P < .05). No statistically significant differences were evident in the mean mycophenolic acid area under the curve between men and women. CONCLUSIONS: There was a high degree of variation between different patients in mycophenolic acid pharmacokinetics early after kidney transplant.

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OBJECTIVES: To determine the mycophenolic acid pharmacokinetic profile early after transplant in Iranian kidney graft recipients. MATERIALS AND METHODS: A cross-sectional study was performed during 6 months in 31 patients who recently had kidney transplant and received fixed doses of mycophenolate mofetil (2 g/d). The plasma levels of mycophenolic acid were determined by high performance liquid chromatography. RESULTS: The mean first mycophenolic acid peak level was 10 ± 5 mg/L. The mean mycophenolic acid area under the curve was 26 ± 19 mgh/L and apparent clearance was 57 ± 55 L/h. The mycophenolic acid area under the curve values of only 8 patients (26%) were within the therapeutic range (30-60 mgh/L). The first, second, and third mycophenolic acid peak levels correlated significantly with mycophenolic acid area under the curve (P < .05). Mycophenolic acid concentration at 10 hours had the highest correlation with mycophenolic acid area under the curve (r=0.962; P < .05). No statistically significant differences were evident in the mean mycophenolic acid area under the curve between men and women. CONCLUSIONS: There was a high degree of variation between different patients in mycophenolic acid pharmacokinetics early after kidney transplant.

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Available abstract

OBJECTIVES: To determine the mycophenolic acid pharmacokinetic profile early after transplant in Iranian kidney graft recipients. MATERIALS AND METHODS: A cross-sectional study was performed during 6 months in 31 patients who recently had kidney transplant and received fixed doses of mycophenolate mofetil (2 g/d). The plasma levels of mycophenolic acid were determined by high performance liquid chromatography. RESULTS: The mean first mycophenolic acid peak level was 10 ± 5 mg/L. The mean mycophenolic acid area under the curve was 26 ± 19 mgh/L and apparent clearance was 57 ± 55 L/h. The mycophenolic acid area under the curve values of only 8 patients (26%) were within the therapeutic range (30-60 mgh/L). The first, second, and third mycophenolic acid peak levels correlated significantly with mycophenolic acid area under the curve (P < .05). Mycophenolic acid concentration at 10 hours had the highest correlation with mycophenolic acid area under the curve (r=0.962; P < .05). No statistically significant differences were evident in the mean mycophenolic acid area under the curve between men and women. CONCLUSIONS: There was a high degree of variation between different patients in mycophenolic acid pharmacokinetics early after kidney transplant.

Key concepts: Mycophenolic acid, Mycophenolate, Pharmacokinetics, Kidney transplant, Area under the curve, Medicine, Urology, Kidney

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