title: Impairment of mycophenolate mofetil absorption by iron ion.
abstract: OBJECTIVE
  We sought to evaluate the effect of iron ion on the absorption of mycophenolate mofetil, which is an immunosuppressive agent. The pharmacokinetics of mycophenolic acid were studied.
  
  
  METHODS
  A randomized crossover design with two phases was used. A 7-day washout period separated the two treatment conditions. In the first phase, the volunteers received 1.0 g of mycophenolate mofetil alone (study 1); in the second phase, the volunteers received 1.0 g of mycophenolate mofetil and 2 tablets of iron ion preparations concomitantly (study 2). The serum concentration of mycophenolic acid, which is a pharmacologically active metabolite, was measured by reverse-phase HPLC.
  
  
  RESULTS
  The area under the plasma concentration-time curve from 0 to 12 hours and the maximum concentration of mycophenolic acid in study 2 were significantly less than in study 1 (area under the curve, 32.9 +/- 14.7 versus 2.92 +/- 0.883 microg x h/mL, P < .001, maximum concentration, 20.1 +/- 9.21 versus 1.30 +/- 0.367 microg x h/mL, P < .001).
  
  
  CONCLUSIONS
  This finding shows that when mycophenolate mofetil and iron ion preparations were administered concomitantly, a remarkable decrease of mycophenolate mofetil absorption was observed. Therefore it seems to be clear that we must avoid the concomitant administration of mycophenolate mofetil and iron ion preparations.
authors.affiliation: Department of Pharmacy and Cardiovascular Surgery, National Cardiovascular Center, Suita-city, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Morii
authors.forename: K
authors.initials: K
authors.lastname: Ueno
authors.forename: A
authors.initials: A
authors.lastname: Ogawa
authors.forename: R
authors.initials: R
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Yoshimura
authors.forename: K
authors.initials: K
authors.lastname: Wada
authors.forename: H
authors.initials: H
authors.lastname: Hashimoto
authors.forename: M
authors.initials: M
authors.lastname: Takada
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Nakatani
authors.forename: M
authors.initials: M
authors.lastname: Shibakawa
mesh_terms: D000328:Adult; D002413:Cations, Divalent; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations; D004347:Drug Interactions; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics*; D007408:Intestinal Absorption / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics*
chemical_list: D002413:Cations, Divalent; D003692:Delayed-Action Preparations; D005296:Ferrous Compounds; D007166:Immunosuppressive Agents; C020748:ferrous sulfate; D009173:Mycophenolic Acid