Mycophenolate pharmacokinetics
Common Questions and Answers about Mycophenolate pharmacokinetics
cellcept
I am being successfully treated for a rare autoimmune condition with 15 mg prednisone and 1 gr mycophenolate daily. Although mycophenolate use involves a risk of opportunistic HSV infections, I was not warned about this.
I recently had sex WITH A CONDOM with a partner whose status for HSV infection is unknown. Within about a day, I had developed numerous lesions. These spread rapidly and my doctor said they had an appearance consistent with HSV.
- Absorption, oral: time to peak concentration 7h
- Elimination half-life = 12 h
(It says also that in general it can be administered once daily because it has a 24 h effect.Why?)
- Can you give another example to clarify it better please?
- When it says divide in 2 doses , does it mean only in the morning and dinner? 3 doses (morning-lunch-dinner)?
Thank you for taking the time to answer!!
additional agents such as mycophenolate (cellcept) may be necessary or in cases of severe rejection a medication such as thymoglobulin may be needed.
My doc is trying to reduce the dose. Since I was on tacrolimus only(as Mycophenolate causes TLC to go down in two occasion), sirolimus 1mg is started along with reduced tacrolimus(2mg BD, Tac level ~4.5). But the creatinine is still high(1.8). It seems some side effect of Sirolimus is also coming as the TLC is 3400 and platelet is 80,000.
What do you suggest to bring creatinine under control?
What is the way to determine the exact required dose of tacrolimus?
The standard therapy options include intravenous immunoglobulin and plasmapharesis, corticosteroids, azathioprine, cyclophosphamide, etanercept, mycophenolate mofetil, interferon alpha 2a and tacrolimus. Current ones are interferon beta 1a, rituximab, and high dose cyclophosphamide. Your neurologist needs to apprise you of the long-term side effects since prolonged therapy are required. Botox shots are not known to be used in therapy.
I can't help out on the pharmacokinetics, but your reasoning is sound: it doesn't make sense to dose so that the drug runs out.
I'd query Schering-Plough as well as your hepatologist, if I were you.
Please give me a heads-up if you solve the riddle.
Hi all
My wife has SLE which about 8 months ago began to come undercontrol with mycophenolate.
t respond to prednisone or azathioprine, your doctor may prescribe stronger immunosuppressants, such as mycophenolate (CellCept), cyclosporine (Neoral, Sandimmune, others) or tacrolimus (Prograf).
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When medication fails to stop the progression of cirrhosis eventually a liver transplant must be considered. This is another reason to also seek treatment with a transplant facility.
And immune suppresant mycophenolate for 6 months. I am grateful for your thoughts. Apologies in delay replying I have been unwell.
I am not on Cellcept which is Mycophenolate Mofetil 1g morning and 1g night. This is a fantastic immunposuppressant. Basically what I am telling you is that at any time your body cannot any longer tolerate one drug, there is always another waiting. The one I am on now is more 'pure' in other words there are less chemicals in in to effect the liver.
It might be worth a mention if you are uncertain but many people are able to tolerate your medication for many years.
Hepatic Impairment
In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (47% for Cmax and 85% for AUC). The pharmacokinetics of sildenafil in patients with severely impaired hepatic function (Child-Pugh Class C) have not been studied. A starting dose of 25 mg should be considered in patients with any degree of hepatic impairment [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3)].
however, there is no documented increased cancer risk specifically with the use of long-term mycophenolate use. the less immunosuppression one takes over time, the better however.
Folic acid supplementation in folate-deficient patients with epilepsy changes the pharmacokinetics of phenytoin, usually leading to lower serum phenytoin concentrations and possible seizure breakthrough..."
It however says that initiation of Folic acid and phenytoin together is beneficial.
Since you can't go back and start all over again, you can take a small dose. It has been observed that as los as 1mg dose can perturb phenytoin’s levels, You may take doses lower than 1mg/day.
The Phase 1 trial was designed to characterize the safety profile of ARC-520 across a range of doses and evaluate pharmacokinetics. It is a single-center, randomized, double-blind, placebo-controlled, single dose-escalation, first-in-human study of ARC-520 administered intravenously to healthy adult volunteers. All subjects have been dosed and received either placebo or ARC-520 in doses ranging from 0.01 mg/kg to 2 mg/kg.
i believe in the pre-clinical trials with healthy volunteers, researchers used Carbon14 to gauge the half-life and paths of elimination during pharmacokinetics studies. it is a common practice. perhaps that is what you are thinking about?
Nitazoxanide, brand name alinia, had also excellent ed50 results in an in vitro inhibition study, just as good as lamuvidine, so this sounded fascinating for a possible combination towards true synergism, to finally suppress virion production to a level so low that the silent daily reinfection will be reduced, allowing a slow net clearance of infected cells with a resulting drop in surface antigen.
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