Impairment of mycophenolate mofetil absorption by iron ion

Objective: We sought to evaluate the effect of iron ion on the absorption o f mycophenolate mofetil, which is an immunosuppressive agent. The pharmacok inetics of mycophenolic acid were studied. Methods: A randomized crossover design with two phases was used. A 7-day wa shout period separated the two treatment conditions. In the first phase, th e volunteers received 1.0 g of mycophenolate mofetil alone (study 1); in th e second phase, the volunteers received 1.0 g of mycophenolate mofetil and 2 tablets of iron ion preparations concomitantly (study 2), The serum conce ntration of mycophenolic acid, which is a pharmacologically active metaboli te, was measured by reverse-phase HPLC, Results: The area under the plasma concentration-time curve from 0 to 12 ho urs and the maximum concentration of mycophenolic acid in study 2 were sign ificantly less than in study I (area under the curve, 32.9 +/- 14.7 versus 2.92 +/- 0.883 mug . h/mL, P < .001, maximum concentration, 20.1 +/- 9.21 v ersus 1.30 +/- 0.367 <mu>g . h/mL, P < .001), Conclusions: This finding shows that when mycophenolate mofetil and iron io n preparations were administered concomitantly, a remarkable decrease of my cophenolate mofetil absorption was observed. Therefore it seems to be dear that we must avoid the concomitant administration of mycophenolate mofetil and iron ion preparations.