title: Do we need to worry about mycophenolate overdose?
abstract: BACKGROUND
  To discuss the significance of the recent observational case series from the Swiss Toxicological Information Centre (STIC). Mycophenolic acid (MPA) and its prodrug mycophenolate mofetil are immunosuppressive agents that are frequently prescribed in renal transplant recipients, and their safety profiles must be established.
  
  
  METHODS
  This case series and systemic literature analysis consists of 15 cases of MPA overdose from the STIC and a systemic analysis of the literature over the past 18 years. This study focuses on acute overdosing, the effects of which are presumably mild. In contrast, the effects of long-term overdosing may be much more severe. Substantial underreporting is likely. The pharmacokinetic monitoring of MPA is rarely performed, which is both striking and does not coincide with findings in academic literature. The scant data on pharmacokinetic monitoring presented demonstrated that MPA has a short terminal half-life, which suggests that decontamination and activated charcoal treatment in acute overdose may not be necessary.
  
  
  CONCLUSIONS
  The case series and systematic literature analysis of acute mycophenolate overdose represent an important contribution toward increasing the safety of MPA therapy.
authors.affiliation: University of Western Ontario, Children's Hospital, Schulich School of Medicine & Dentistry, London Health Sciences Centre, Department of Paediatrics , 800 Commissioners Road East, London, ON N6A 5W9 , Canada.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.forename: Amaryllis
authors.initials: A
authors.lastname: Ferrand
mesh_terms: D062787:Drug Overdose / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid