Question

Which of the following statements about mycophenolate mofetil is not true?

• A. Most common adverse effect is nephrotoxicity
• B. Used in transplant rejection
• C. It is a prodrug and converted to mycophenolic acid
• D. Is not used with azathioprine

Hint:

Mycophenolate mainly upsets the gut and marrow; the kidney-toxic drugs are the calcineurin inhibitors.

Answer 1

The Correct Option is A

Step 1: Mycophenolate mofetil (MMF) is an immunosuppressant. We must identify the false statement.

Step 2: Check option A. MMF inhibits inosine monophosphate dehydrogenase, blocking de novo purine synthesis in lymphocytes. Its main adverse effects are gastrointestinal upset (diarrhea, vomiting, abdominal pain) and bone marrow suppression (leukopenia). It is not characteristically nephrotoxic; that toxicity belongs to calcineurin inhibitors like cyclosporine. So calling nephrotoxicity its commonest adverse effect is false.

Step 3: Check option B. MMF is widely used to prevent and treat solid organ transplant rejection, usually with a calcineurin inhibitor and steroids. So B is true.

Step 4: Check option C. MMF is an inactive prodrug, an ester that is hydrolysed to the active mycophenolic acid after absorption. So C is true.

Step 5: Check option D. MMF and azathioprine are both antiproliferative agents that suppress purine pathways, so they are not combined because of overlapping marrow toxicity. So D is true.

Conclusion: The false statement is that its most common adverse effect is nephrotoxicity, option A.