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Pediatric Nephrology

, Volume 21, Issue 8, pp 1206–1208 | Cite as

Unexpectedly high exposure to enteric-coated mycophenolate sodium upon once-daily dosing

  • Guido FillerEmail author
  • Anita Lathia
  • Claire LeBlanc
  • Uwe Christians
Brief Report

Abstract

Enteric-coated mycophenolate sodium (EC-MPS) has a mean half-life of 11.7 hours, which encouraged hope of using this drug once daily in a nonadherent adolescent SLE patient. This is a case report on a 17-year-old adolescent with a history of noncompliance who was switched from twice-daily mycophenolate mofetil (MMF) to once-daily EC-MPS. The EC-MPS dose was equimolar to the daily MMF dose (1 g MMF BID and 1.44 g of EC-MPS OD). The active compound of both drugs, mycophenolic acid, was measured using a commercially available EMIT assay. Both drugs were well-tolerated and maintained remission of the SLE. The average of three 12-hour areas under the time–concentration curves (AUC) on 1 g of MMF BID was 59.0 mg×h/L. In contrast, the 24-hour AUC after 1.44 g EC-MPS OD was 283.2 mg×h/L, more than double the expected 118.0 mg×h/L of two MMF dosing intervals. A repeat 24-hour AUC after 1.08 g of EC-MPS was 218.2 mg×h/L. EC-MPS once daily may be a well-tolerated therapeutic option for nonadherent adolescent lupus patients, but may be associated with a significantly higher exposure than the equivalent MMF BID dose.

Keywords

EC-MPS Mycophenolate sodium MMF Mycophenolic acid Systemic lupus erythematosus 

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Guido Filler
    • 1
    Email author
  • Anita Lathia
    • 1
  • Claire LeBlanc
    • 2
  • Uwe Christians
    • 3
  1. 1.Division of Nephrology, Children’s Hospital of Eastern OntarioUniversity of OttawaOttawaCanada
  2. 2.Division of Rheumatology, Department of PediatricsChildren’s Hospital of Eastern OntarioOttawaCanada
  3. 3.Department of AnesthesiologyUniversity of Colorado Health Science CenterDenverUSA

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