It is metabolized in the liver via the cytochrome P-450 system. Toxicity is similar to that of cyclosporine, with nephrotoxicity being a major adverse effect. Tacrolimus should not be administered concomitantly with cyclosporine. The drug inhibits nucleic acid synthesis, suppressing cell-mediated hypersensitivity and altering antibody production. Azathioprine is metabolized in the liver and erythrocytes.
Renal function has minor effects on levels.
The drug causes a dose-dependent reduction in leukocyte and platelet counts. Development of severe renal dysfunction warrants closer monitoring with possible reduction in dosage. The major toxic effects are neutropenia and thrombocytopenia. Mycophenolate Mycophenolate mofetil is an antibiotic isolated from Penicillium species that has immunosuppressant properties. While currently approved in renal transplantation, mycophenolate is being used in liver and heart transplantation with increasing frequency.