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Updated: Aug 17, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Impact of mycophenolate mofetil loading on drug exposure in the early posttransplant period

B A Kiberd1, J J Puthenparumpil, A Fraser

  • 1Department of Medicine, Dalhousie University, 5082 AC Dickson, Queen Elizabeth II HSC-VG site, Halifax, Nova Scotia B3H 2Y9, Canada.

Transplantation Proceedings
|June 21, 2005
PubMed
Abstract

Insights

Higher doses of mycophenolate mofetil improve drug exposure in kidney transplant patients, particularly those on tacrolimus. This enhances the likelihood of achieving therapeutic levels for better rejection prevention.

Area of Science:

  • Pharmacology
  • Transplantation Medicine
  • Nephrology

Background:

  • Achieving adequate therapeutic levels of immunosuppressive medications is crucial for preventing rejection in kidney transplant recipients.
  • Mycophenolic acid (MPA) is a key immunosuppressant, and its exposure needs careful monitoring post-transplantation.

Purpose of the Study:

  • To examine the exposure to mycophenolic acid (MPA) in kidney transplant patients within the first 5 days posttransplantation.
  • To compare the impact of different mycophenolate mofetil (MMF) doses on MPA exposure in patients receiving either cyclosporine or tacrolimus.

Main Methods:

  • Single-center, nonrandomized study involving first solitary kidney allograft recipients.
  • Patients received either 1 g or 1.5 g of mycophenolate mofetil (MMF) twice daily, starting postoperatively.
  • MPA exposure was measured at days 3 and 5 posttransplant using limited sampling time equations.

Main Results:

  • No significant difference in MPA exposure was observed between 2-g and 3-g daily MMF doses in cyclosporine-treated patients.
  • Approximately half of the patients in both cyclosporine groups had MPA exposure below 30 mg*h/L.
  • Tacrolimus-treated patients receiving a 3-g daily MMF dose showed significantly greater MPA exposure on day 3 compared to those on a 2-g dose.

Conclusions:

  • Higher doses of MMF lead to increased MPA exposure.
  • Higher MMF doses show a trend towards more patients achieving therapeutic MPA levels within the first week in tacrolimus-treated patients, but not in cyclosporine-treated patients.

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