Enteric-coated mycophenolate sodium: one-way conversion from mycophenolate mofetil and de novo use in stable liver transplant recipients.
Enteric-coated mycophenolate sodium (EC-MPS) is a formulation of mycophenolic acid (MPA) that releases the active molecule in the intestine reducing drug-related gastrointestinal (GI) side effects. The aim of present work was to summarize the use of EC-MPS for one-way conversion from mycophenolate mofetil (MMF) due to GI side effects and for de novo administration in a stable liver transplant population. In 10 patients on MMF and low-dose calcineurin inhibitors (CNI), significant GI side effects suggested drug conversion to ameliorate subjective symptoms. In 5 patients, EC-MPS was initiated de novo together with reduction of CNI for prevention of long-term renal failure. Conversion was carried out at equivalent MMF/EC-MPS dosages. Reevaluation at 2 months after conversion showed that no episode of rejection or infection occurred, and white blood cell count, CNI levels and doses, and creatinine clearance did not vary significantly. In 70% of converted patients there was a reduction of GI symptoms, especially diarrhea. Eighty percent suspended proton pump inhibitors. The de novo-treated patients showed no significant GI side effects. In conclusion, conversion from MMF to EC-MPS demonstrated significant GI symptom relief and de novo drug administration was well tolerated.
Nure
E
E
Department of Surgery, Catholic University of Rome, U.O. Chirurgia Sostitutiva, Policlinico "A. Gemelli," Rome, Italy. eridanure@yahoo.it
Magalini
S C
SC
Frongillo
F
F
Barbarino
R
R
Pepe
G
G
Avolio
A W
AW
Agnes
S
S
D004304:Dosage Forms; D041981:Gastrointestinal Tract / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016031:Liver Transplantation; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D004304:Dosage Forms; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid