Medicine & USMLE


  1. Cyclosporine
  2. Tacrolimus
  3. Sirolimus (Rapamycin)
  4. Basiliximab
  5. Mycophenolate


Mycophenolate is an immunosuppressant drug that is used to prevent transplant rejections and in the treatment of lupus nephritis. Mycophenolate achieves its immunosuppressive effects by blocking IMP dehydrogenase, an enzyme involved in the de novo synthesis for purines. Since T-cells and B-cells rely heavily on purines synthesized from this pathway, mycophenolate effectively blocks these lymphocytes from replicating, thereby suppressing the immune system. Although mycophenolate causes many general side effects, the most important to note is an increased risk of cytomegalovirus (CMV) infection.

Key Points

  • Mycophenolate
    • Immunosuppressant drug
      • Used in transplant rejection prophylaxis and the treatment of lupus nephritis 
    • Mechanism
      • Inhibits IMP dehydrogenase
      • Impairs lymphocyte proliferation (e.g. B and T cells)
        • B- and T-cells heavily dependent on de novo synthesis of purines
    • Adverse Effects
      • Associated with invasive CMV infection
        • Thought to be related to lymphocyte suppression
      • GI upset (nausea/vomiting)
      • Myelosuppression (pancytopenia)
      • Hypertension
      • Hyperglycemia