Indicatie voor therapeutic drug monitoring van mycofenolzuur

Mycophenolic acid (MPA) is the active component of the prodrugs mycophenolate mofetil and mycophenolate sodium. Exposure to MPA is highly variable and therefore therapeutic drug monitoring (TDM) of MPA is considered useful to optimize exposure to MPA and subsequently improve clinical outcome. This review aims at providing a practical overview of the current do's and don'ts for TDM of MPA. The pharmacokinetics of MPA, current dosing guidelines, target plasma concentrations of MPA and what to measure and how often when performing TDM of MPA are addressed. For renal transplant recipients, a TDM scheme for MPA consisting of four measurements of MPA exposure in the first month after transplantation is advised to reach and maintain target MPA AUC values of 30-60 mg·l-1·h.