TY - JOUR
T1 - Intravenous mycophenolate mofetil
T2 - Safety, tolerability, and pharmacokinetics
AU - Pescovitz, Mark D.
AU - Conti, D.
AU - Dunn, J.
AU - Gonwa, T.
AU - Halloran, P.
AU - Sollinger, H.
AU - Tomlanovich, S.
AU - Weinstein, S.
AU - Inokuchi, S.
AU - Kiberd, B.
AU - Kittur, D.
AU - Merion, R. M.
AU - Norman, D.
AU - Shoker, A.
AU - Wilburn, R.
AU - Nicholls, A. J.
AU - Arterburn, S.
AU - Dumont, E.
PY - 2000
Y1 - 2000
N2 - An intravenous (i.v.) formulation of mycophenolate mofetil (MMF; CellCept®, Roche Pharmaceuticals, Inc., Palo Alto, CA) that will enable its administration to patients unable to tolerate oral medication is available. Two separate studies, an open-labeled pharmacokinetic (PK) study and a double-blind safety study, were performed. Within 24 h after transplant, 153 (safety study) and 45 (PK study) first or second renal transplant recipients were started on i.v. MMF 1 g Q12h or placebo (used in the safety study only, 2:1 MMF:placebo), given over 2 h via a dedicated peripheral venous catheter. In the safety study, per os (p.o.) MMF (1 g Q12h) or placebo was administered, starting within 72 h after transplant, whereas in the PK study, p.o. MMF was started on the evening of day 5. Sequential blood samples obtained on study days 5 (i.v. MMF) and 6 (p.o. MMF) before and up to 12 h after the AM dose were analyzed for mycophenolic acid (MPA) and MPA glucuronide (MPAG) concentrations by high-performance liquid chromatography. The area under the concentration curve (AUC) was calculated using the linear trapezoidal rule. The MPA AUC0-12 was higher for i.v. MMF than p.o. MMF (40.8 ± 11.4 μg.h/mL vs. 32.9 ± 15, p < 0.001). There were no other significant PK differences for plasma MPA or MPAG. In the safety study (n = 98 i.v. MMF vs. n = 55 placebo), 11 patients (11%, i.v. MMF) and 4 patients (7%, placebo) discontinued their use of the drug because of an adverse event (AE). Overall, AEs were similar between i.v. MMF and placebo. Injection site phlebitis (4%) and thrombosis (4%) were observed only with i.v. MMF. MMF i.v. 1 g twice daily (b.i.d.) should provide efficacy at least equivalent to p.o. MMF without increased toxicity, and it provides an acceptable alternative dose form in the immediate period after transplant.
AB - An intravenous (i.v.) formulation of mycophenolate mofetil (MMF; CellCept®, Roche Pharmaceuticals, Inc., Palo Alto, CA) that will enable its administration to patients unable to tolerate oral medication is available. Two separate studies, an open-labeled pharmacokinetic (PK) study and a double-blind safety study, were performed. Within 24 h after transplant, 153 (safety study) and 45 (PK study) first or second renal transplant recipients were started on i.v. MMF 1 g Q12h or placebo (used in the safety study only, 2:1 MMF:placebo), given over 2 h via a dedicated peripheral venous catheter. In the safety study, per os (p.o.) MMF (1 g Q12h) or placebo was administered, starting within 72 h after transplant, whereas in the PK study, p.o. MMF was started on the evening of day 5. Sequential blood samples obtained on study days 5 (i.v. MMF) and 6 (p.o. MMF) before and up to 12 h after the AM dose were analyzed for mycophenolic acid (MPA) and MPA glucuronide (MPAG) concentrations by high-performance liquid chromatography. The area under the concentration curve (AUC) was calculated using the linear trapezoidal rule. The MPA AUC0-12 was higher for i.v. MMF than p.o. MMF (40.8 ± 11.4 μg.h/mL vs. 32.9 ± 15, p < 0.001). There were no other significant PK differences for plasma MPA or MPAG. In the safety study (n = 98 i.v. MMF vs. n = 55 placebo), 11 patients (11%, i.v. MMF) and 4 patients (7%, placebo) discontinued their use of the drug because of an adverse event (AE). Overall, AEs were similar between i.v. MMF and placebo. Injection site phlebitis (4%) and thrombosis (4%) were observed only with i.v. MMF. MMF i.v. 1 g twice daily (b.i.d.) should provide efficacy at least equivalent to p.o. MMF without increased toxicity, and it provides an acceptable alternative dose form in the immediate period after transplant.
KW - Intravenous (i.v.)
KW - Kidney transplantation
KW - Mycophenolate mofetil
KW - Pharmacokinetics
KW - Safety
UR - http://www.scopus.com/inward/record.url?scp=0034093785&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034093785&partnerID=8YFLogxK
U2 - 10.1034/j.1399-0012.2000.140301.x
DO - 10.1034/j.1399-0012.2000.140301.x
M3 - Article
C2 - 10831074
AN - SCOPUS:0034093785
SN - 0902-0063
VL - 14
SP - 179
EP - 188
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 3
ER -