title: Mycophenolate revisited.
abstract: The patent of mycophenolate mofetil (MMF) has expired, and for enteric-coated mycophenolate sodium (EC-MPS), this will happen in 2017. In the twenty years these drugs have been used, they have become extremely popular. In this review, the reasons for the popularity of mycophenolate are discussed, including the benefits compared to azathioprine. MMF and EC-MPS are therapeutically equivalent. Although neither is considered to be a narrow therapeutic index drug, this should not lead to careless switching between the innovator drug and generic formulations, or between one generic formulation and another. The pipeline of new immunosuppressive drugs is dry, and it is very likely that we will be using mycophenolate for many more years to come as a first-line immunosuppressive drug in our transplant population. Whether or not the development of donor-specific anti-HLA antibodies is related to drug exposure (mycophenolic acid concentrations) remains to be investigated.
authors.affiliation: Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: van Gelder
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Hesselink
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D016903:Drug Monitoring / Q000379:methods*; D016568:Drugs, Generic / Q000627:therapeutic use; D014644:Genetic Variation; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013608:Tablets, Enteric-Coated
chemical_list: D016568:Drugs, Generic; D007166:Immunosuppressive Agents; D013608:Tablets, Enteric-Coated; D009173:Mycophenolic Acid; D001379:Azathioprine
keywords: generic; mycophenolate mofetil; mycophenolic acid; therapeutic drug monitoring; transplantation