At a Glance
Why Get Tested?
To determine the concentration of mycophenolic acid (MPA), an immunosuppressant drug, in the blood in order to monitor levels in transplant recipients and prevent toxicity
When to Get Tested?
As soon as mycophenolate therapy begins and whenever the dose is changed; may be ordered frequently at first, then at regular intervals; whenever excess or deficient levels of MPA are suspected
A blood sample drawn from a vein in your arm
Test Preparation Needed?
The Test Sample
What is being tested?
Mycophenolic acid (MPA) is the active metabolite of mycophenolate, a drug that is primarily given to people who have had a heart, kidney, or liver transplant to help prevent rejection and secondarily to people with a variety of autoimmune disorders. This test measures the amount of mycophenolic acid in the blood.
Normally, a healthy immune system distinguishes the body's own healthy tissue (self) from threats such as viruses, bacteria, and parasites (non-self). However, the immune system recognizes a transplanted organ as non-self and may attack it. In the case of autoimmune disorders, the immune system mistakenly targets the body's own cells and tissues, causing damage and inflammation.
Mycophenolate belongs to a group of drugs called immunosuppressants that suppress the immune system and helps to prevent organ rejection, tissue inflammation, and damage. Mycophenolate acts by inhibiting formation of an enzyme necessary to produce special immune cells called T-lymphocytes and B-lymphocytes. Inhibiting lymphocyte formation decreases both immune system function and antibody production, reducing the body's immune response to transplanted organs or to its own tissues and cells.
Organ transplant recipients receive mycophenolate in conjunction with other immunosuppressant drugs such as cyclosporine and tacrolimus. Autoimmune disorder patients may be prescribed mycophenolate as a single agent, although they may take other medications. It has been used to treat lupus (especially with symptoms of kidney disease), rheumatoid arthritis, vasculitis, inflammatory bowel disease such as Crohns disease, inflammatory eye diseases including iritis and scleritis, and some other kidney or skin disorders.
Mycophenolate, like most immunosuppressants, must be maintained within a narrow therapeutic range. If the level is too low, organ rejection may occur; if it is too high, then the person may develop toxicity. The mycophenolic acid blood test uses blood samples collected when the drugs are at their lowest, typically just prior to the next dose. Such levels are called trough levels and they are correlated to clinical side effects.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Mycophenolate Mofetil (CellCept) and Mycophenolate Sodium (Myfortic). American College of Rheumatology. Available online at http://www.rheumatology.org/practice/clinical/patients/medications/mycophenolate.asp through http://www.rheumatology.org. Last updated May 2012. Accessed December 10, 2014.
Mycophenolate. MedlinePlus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601081.html through http://www.nlm.nih.gov. Last updated June 15, 2014. Accessed December 10, 2014.
Myfortic. Rx List. Available online at http://www.rxlist.com/myfortic-drug/patient-images-side-effects.htm through http://www.rxlist.com. Copyright 2014. Accessed December 10, 2014.
Mycophenolate Mofetil (Oral Route). Mayo Clinic. Available online at http://www.mayoclinic.org/drugs-supplements/mycophenolate-mofetil-oral-route/side-effects/drg-20073191 through http://www.mayoclinic.org. Last updated September 1, 2014. Accessed December 10, 2014.
Mycophenolic Acid Drug Level. University of Iowa Department of Pathology. Available online at https://www.healthcare.uiowa.edu/path_handbook/handbook/test1087.html through https://www.healthcare.uiowa.edu. Last updated September 18, 2012. Accessed December 29, 2014.
Mycophenolic Acid, Serum. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81563 through http://www.mayomedicallaboratories.com. Copyright 1995-2014. Accessed December 29, 2014.
Mycophenolic Acid and Metabolites. ARUP Laboratories. Available online at http://ltd.aruplab.com/Tests/Pub/2010359 through http://ltd.aruplab.com. Copyright 2014. Accessed December 29, 2014.
Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2011, Pp 354-355.
Sources Used in Previous Reviews
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 1416-1419.
Bhorade, S. (2006 December, Revised). Medicines for Keeping Your New Heart or Lung Healthy. AST [On-line information]. PDF available for download at http://www.a-s-t.org/files/pdf/patient_education/english/AST-EdBroHEARTMED-ENG.pdf through http://www.a-s-t.org. Accessed on 11/10/07.
Aradhye, S. (2006 December, Revised). Medicines for Keeping Your New Kidney Healthy. AST [On-line information]. PDF available for download at http://www.a-s-t.org/files/pdf/patient_education/english/AST-EdBroKIDNEYMED-ENG.pdf through http://www.a-s-t.org. Accessed on 11/10/07.
(2007 August 1). Mycophenolate. MedlinePlus Drug Information [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601081.html through http://www.nlm.nih.gov. Accessed on 11/7/07.
Cannon, M. (2006 June, Updated). Mycophenolate Mofetil. CR [On-line information]. Available online at http://www.rheumatology.org/public/factsheets/mycophenolate.asp through http://www.rheumatology.org. Accessed on 11/10/07.
Waknine, Y. (2006 June 9). New FDA Orphan Drugs: CellCept, ISIS 301012, 5-HMF. Medscape Medical News [On-line information]. Available online at http://www.medscape.com/viewarticle/535806 through http://www.medscape.com. Accessed on 11/10/07.
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Waknine, Y. (2007 October 29). CellCept Linked to Pregnancy Loss, Congenital Malformations. Medscape Medical News [On-line information]. Available online at http://www.emedicine.com/med/TOPIC3558.HTM through http://www.emedicine.com. Accessed on11/10/07.
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(© 2007). Mycophenolic Acid. ARUP's Laboratory Test Directory [On-line information]. Available online at http://www.aruplab.com/guides/ug/tests/0090213.jsp through http://www.aruplab.com. Accessed on 11/10/07.
(© 2007). Mycophenolic Acid and Metabolite. LabCorp [On-line information]. Available online at http://www.labcorp.com/datasets/labcorp/html/chapter/ through http://www.labcorp.com. Accessed on 11/10/07.
(© 1998-2001). CellCept®. Roche.
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(December 12 2009). MedlinePlus Drug Information. Mycophenolate. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601081.html. Accessed August 2011.
(May 20, 2008) Transplant Living. Mycophenolic Acid. Available online through http://www.transplantliving.org. Accessed August 2011.
(©2010) American College of Rheumatology. Practice Management, Mycophenolate. Available online at http://www.rheumatology.org/practice/clinical/patients/medications/mycophenolate.asp through http://www.rheumatology.org. Accessed August 2011.
(July 14, 2009) U.S. Food and Drug Administration. Information for Healthcare Professionals: Immunosuppressant Drugs: Required Labeling Changes. Available online through http://www.fda.gov/. Accessed July 2011.
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(©2011) Cleveland Clinic. Transplant programs: Mycophenolate Mofetil. Available online at http://my.clevelandclinic.org/transplant/services/kidney/mycophenolate.aspx through http://my.clevelandclinic.org. Accessed August 2011 .
(©2011) eMedicine Health. Drugs and Medications, Mycophenolate Mofetil. Available online at http://www.emedicinehealth.com/drug-mycophenolate_mofetil/article_em.htm through http://www.emedicinehealth.com. Accessed August 2011 .
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry, AACC Press, Washington, DC. Pg 463.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed., Burtis CA and Ashwood ER, eds. Philadelphia: W. B. Saunders Company; 2005. Pp 1277-1278.
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