Author(s):
Shreya Jain, Shankar Prasad Nagaraju, Priya Rani, Mohan V Bhojaraja, Attur Ravindra Prabhu, Dharshan Rangaswamy, Indu Ramachandra Rao, Srinivas Vinayak Shenoy
Email(s):
mohan.vb@manipal.edu
DOI:
10.52711/0974-360X.2026.00420 
Address:
Shreya Jain, Shankar Prasad Nagaraju, Priya Rani, Mohan V Bhojaraja, Attur Ravindra Prabhu, Dharshan Rangaswamy, Indu Ramachandra Rao, Srinivas Vinayak Shenoy
Department of Nephrology, Kasturba Medical College, Manipal Academy of Higher Education , Manipal, India.
*Corresponding Author
Published In:
Volume - 19,
Issue - 7,
Year - 2026
ABSTRACT:
The optimal dosing strategy for “mycophenolate mofetil” (MMF) in renal transplant recipients under “tacrolimus-based immunosuppression” remains uncertain. This retrospective study assessed the safety and effectiveness of two MMF dosages—1.5g/day and 2g/day—among adult patients who underwent “live-related kidney transplants” at a tertiary care institution between January 2018 and December 2022. Participants were split into two groups: Group 1(n = 20) received 1.5g/day, while Group 2(n = 42) received 2g/day. All individuals were managed with standard triple immunosuppressive therapy and showed comparable baseline profiles and tacrolimus trough concentrations. Primary outcomes evaluated included the occurrence of leukopenia, infection rates, and episodes of acute rejection. Secondary endpoints focused on one-year graft performance and overall patient survival. A significantly greater incidence of leukopenia (47.6% vs. 20%; p = 0.04) and infections (35.7% vs. 10%; p = 0.03) was observed in the 2g/day group compared to the 1.5g/day group. However, there was no statistically significant decrease in acute rejection episodes (54.8% vs. 45%; p = 0.47) with the higher dosage. Renal function at one year, measured by estimated glomerular filtration rate (eGFR), was nearly identical between groups (69.3±23.2 vs. 68.2±22.8mL/min/1.73m²; p = 0.86), and no differences were found in graft or patient survival. In conclusion, starting MMF at 2g/day in patients receiving tacrolimus may lead to an increased risk of hematologic and infectious side effects without yielding measurable advantages in rejection control or long-term clinical outcomes. These results support the consideration of a reduced initial MMF dose as a safer yet equally effective approach.
Cite this article:
Shreya Jain, Shankar Prasad Nagaraju, Priya Rani, Mohan V Bhojaraja, Attur Ravindra Prabhu, Dharshan Rangaswamy, Indu Ramachandra Rao, Srinivas Vinayak Shenoy. Initial Mycophenolate Mofetil Dose in Live-related Kidney Transplant Recipients in Indian Context: Are We Overdosing?. Research Journal of Pharmacy and Technology. 2026;19(7):2947-3. doi: 10.52711/0974-360X.2026.00420
Cite(Electronic):
Shreya Jain, Shankar Prasad Nagaraju, Priya Rani, Mohan V Bhojaraja, Attur Ravindra Prabhu, Dharshan Rangaswamy, Indu Ramachandra Rao, Srinivas Vinayak Shenoy. Initial Mycophenolate Mofetil Dose in Live-related Kidney Transplant Recipients in Indian Context: Are We Overdosing?. Research Journal of Pharmacy and Technology. 2026;19(7):2947-3. doi: 10.52711/0974-360X.2026.00420 Available on: https://rjptonline.org/AbstractView.aspx?PID=2026-19-7-7
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