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Mycophenolate mofetil, a prodrug form of mycophenolic acid used in medicine. Mycophenolate mofetil is the morpholino ethyl ester of mycophenolic acid; the ester masks the carboxyl group. [42] Mycophenolate mofetil is reported to have a pKa values of 5.6 for the morpholino moiety and 8.5 for the phenolic group.
Other cytotoxic antibiotics are anthracyclines, mitomycin C, ... Mycophenolate mofetil is used in combination with ciclosporin or tacrolimus in transplant patients.
Non-cytotoxic immunosuppressive treatments usually include the anti-rejection transplant drugs azathioprine (Imuran/Azoran) and mycophenolate mofetil (Cellcept). In the U.S., these drugs are used "off-label", meaning that they do not have an indication for the treatment of CIDP in their package inserts.
It is mostly well tolerated (though side effects include mucositis, diarrhea, hyperlipidemia, delayed wound healing) with drug-drug interactions. It has better activity against autoimmune disease and lymphoproliferation than mycophenolate mofetil and other drugs; however, sirolimus requires therapeutic drug monitoring and can cause mucositis.
The risk is especially high in cytotoxic chemotherapy for leukemia. In the case of non-small-cell lung cancer, myelosuppression predisposition was shown to be modulated by enhancer mutations. [3] Nonsteroidal anti-inflammatory drugs (NSAIDs), in some rare instances, may also cause bone marrow suppression. The decrease in blood cell counts does ...
Azathioprine is used alone or in combination with other immunosuppressive therapy to prevent rejection following organ transplantation, and to treat an array of autoimmune diseases, including rheumatoid arthritis, pemphigus, systemic lupus erythematosus, Behçet's disease, and other forms of vasculitis, autoimmune hepatitis, atopic dermatitis, myasthenia gravis, neuromyelitis optica (Devic's ...
Other third line options, that are less studied, include azathioprine, cyclophosphamide, cyclosporine, mycophenolate mofetil and bortezomib. [4] The treatments for secondary warm AIHA are generally the same as primary warm AIHA, but with the addition of treating the underlying disease if possible. [4]
Methotrexate or mycophenolate mofetil along with folic acid supplements are examples of second-line therapy. [19] If all previous treatments are ineffective, third-line treatments such as thalidomide or lenalidomide may be considered. [4] [20] Another effective treatment for suppressive, non-curative conditions is pulse dye laser. [21]