Mycophenolate Mofetil (Cellcept)- Inhibits de novo purine synthesis by inhibiting inosine monophosphate dehydrogenase (IMPDH); T and B cells particularly affected; excreted by kidneys
- After ingestion, active metabolite is mycophenolic acid; deactivated by liver but “reactivated” by both epidermis and GI tract
- SE: nausea, vomiting, reversible dose-related bone marrow toxicity, progressive multifocal leukoencephalopathy, pure red cell aplasia
- Caution in peptic ulcer disease; of note, not hepatotoxic or nephrotoxic
- Pregnancy category D
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