Enteric-coated mycophenolate sodium - current and future use in transplant patients

Mycophenolate mofetil, the morpholino ester prodrug of mycophenolic acid, is an effective immunosuppressant, although there are concerns over dose reductions and discontinuations due to gastrointestinal adverse events. Enteric-coated mycophenolate sodium (Myfortic) was formulated to improve mycophenolic acid-related upper gastrointestinal adverse events and to deliver effective mycophenolic acid protection. Enteric-coated mycophenolate sodium 720 mg and mycophenolate mofetil 1000 mg are therapeutically equivalent in de novo transplant patients. Conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in maintenance patients can be achieved without compromising safety and efficacy. Recent studies demonstrate the efficacy and tolerability of enteric-coated mycophenolate sodium in adult and pediatric renal transplant patients converted from mycophenolate mofetil, and early results also suggest that enteric-coated mycophenolate sodium can provide similar efficacy and safety as mycophenolate mofetil in de novo heart transplant patients.