II. Indications

III. Mechanism

  1. Mycophenolic acid (MPA) derivative
  2. Reversibly inhibits inosine monophosphate dehydrogenase (IMPDH)
  3. Primarily effects T Cell and B Cell proliferation and Antibody production

IV. Dosing

  1. Dose: 500-1000 mg twice daily

V. Adverse effects

  1. Infection
  2. Malignancy (e.g. skin cancer, Lymphoma)
  3. Neutropenia
  4. Gastrointestinal Bleeding
  5. Nausea or Vomiting

VI. Monitoring

  1. PPD before starting therapy
  2. Complete Blood Count
    1. Obtain baseline
    2. Obtain weekly for first month, twice monthly for next 2 months and then monthly

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