Monitoring and Management of Mycophenolate Mofetil Therapy in Adult Renal Transplant Recipients

Laboratory Monitoring

• Perform a complete blood count with differential and a comprehensive metabolic panel 2–3 weeks after initiating mycophenolate mofetil, 2–3 weeks after any dose increase, and then every 3 months once the dose is stable to detect hematologic or metabolic toxicity. 1

Management of Gastrointestinal Adverse Effects

• If the recipient develops gastrointestinal adverse effects (e.g., diarrhea), temporarily discontinue mycophenolate mofetil or reduce the dose to mitigate toxicity. The recommendation is supported by multiple sources. 2, 3, 4

Therapeutic Drug Monitoring

• When gastrointestinal intolerance occurs, obtain plasma mycophenolic acid (MPA) concentrations to assess whether mycophenolate is the causative agent of the symptoms. 2, 4