Description

Mycophenolate Mofetil (MMF) is an ester prodrug of mycophenolic acid (MPA). This means that it is an inactive compound that is converted into the active drug (MPA) in the body. It is a potent immunosuppressive agent used to prevent the immune system from attacking a transplanted organ.

Indication

The primary indication for Mycophenolate Mofetil is to prevent organ rejection in patients who have received a kidney, heart, or liver transplant. It is typically used in combination with other medications like cyclosporine or corticosteroids. It is also used “off-label” to treat various autoimmune and inflammatory conditions, such as lupus, rheumatoid arthritis, and psoriasis.

Mechanism of Action

Mycophenolate Mofetil is converted into its active metabolite, mycophenolic acid (MPA). MPA is a potent, selective, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). This enzyme is crucial for the de novo pathway of guanosine nucleotide synthesis.

The key to its mechanism is that B and T lymphocytes, which are the immune cells responsible for transplant rejection, are highly dependent on this de novo pathway for their proliferation. By inhibiting IMPDH, MPA effectively blocks the replication of these lymphocytes, thereby suppressing the immune response and preventing the rejection of the transplanted organ.