Mycophenolic acid (MPA) is an immunosuppressive agent used to prevent rejection in organ transplantation.
We recently have published this pathway summary in the Pharmacogenetics and Genomics Journal.
The article and included figure describe the metabolism of MPA and its prodrug mycophenolate mofetil. MPA is a noncompetitive, selective and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). The pharmacodynamic section shows several mechanisms of actions.
Interindividual variability in the MPA exposure levels within and among populations has been observed. The article summarizes studies reporting the clinical association of genetic variants in PK and PD genes with MPA exposure and risk of rejection or GI toxicity (one of the major toxicities associated with MPA).