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Year : 2010  |  Volume : 20  |  Issue : 1  |  Page : 51-53

Mycophenolic acid area under the curve recovery time following rifampicin withdrawal

1 Department of Nephrology, Christian Medical College, Vellore, India
2 Department of Clinical Pharmacology, Christian Medical College, Vellore, India

Correspondence Address:
G T John
Senior Consultant, Department of Renal Medicine, Level 9, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Herston QLD 4029, Australia

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-4065.62091

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Renal transplant patients prescribed mycophenolate mofetil (MMF) may require treatment for tuberculosis with a regimen including the tuberculocidal drug rifampicin. MMF is an ester prodrug which is rapidly hydrolysed to the active compound, mycophenolic acid (MPA). Therapeutic drug monitoring of mycophenolate involves the measurement of MPA area under the curve (MPA-AUC 0-12 ). Rifampicin is known to increase the metabolism and decrease enterohepatic recirculation of mycophenolic acid, (MPA). When MPA is monitored after the discontinuation of rifampicin, an important factor is the time required for the MPA area under the curve to return to the pre-rifampicin value. At present this is not known. This report describes one such renal allograft patient, on long term MMF and prescribed rifampicin by a local physician. As expected there was a clinically significant decrease in MPA-AUC 0-12 . Three weeks after rifampicin was discontinued the MPA-AUC 0-12 was still only 65% of the pre-rifampicin value and only 55% of the steady state MPA-AUC 0-12 measured six months later.


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Indian Journal of Nephrology
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Online since 20th Sept '07