אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 1 mg - capsule, modified release - excipient ingredients: hypromellose; iron oxide yellow; gelatin; sodium lauryl sulfate; titanium dioxide; ethylcellulose; iron oxide red; magnesium stearate; lactose monohydrate; hyprolose; butan-1-ol; purified water; industrial methylated spirit; simethicone; lecithin; ethanol; shellac; strong ammonia solution; sulfuric acid - advagraf xl is indicated for use as an adjunct to liver, kidney, lung or heart allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 0.5 mg - capsule, modified release - excipient ingredients: iron oxide yellow; hypromellose; iron oxide red; titanium dioxide; lactose monohydrate; ethylcellulose; magnesium stearate; sodium lauryl sulfate; gelatin; hyprolose; butan-1-ol; purified water; industrial methylated spirit; simethicone; lecithin; ethanol; shellac; strong ammonia solution; sulfuric acid - advagraf xl is indicated for use as an adjunct to liver, kidney, lung or heart allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 0.5 mg - capsule, hard - excipient ingredients: lactose monohydrate; croscarmellose sodium; purified water; iron oxide yellow; magnesium stearate; hypromellose; titanium dioxide; gelatin; butan-1-ol; hyprolose; iron oxide red; industrial methylated spirit; simethicone; lecithin; ethanol; shellac; strong ammonia solution; sulfuric acid - prograf is indicated for use as an adjunct to liver, kidney, heart or lung allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 5 mg/ml - injection, concentrated - excipient ingredients: peg-60 hydrogenated castor oil; ethanol - prograf is indicated for use as an adjunct to liver, kidney, heart or lung allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 5 mg - capsule, hard - excipient ingredients: lactose monohydrate; hypromellose; iron oxide red; gelatin; magnesium stearate; titanium dioxide; croscarmellose sodium; propylene glycol; butan-1-ol; isopropyl alcohol; ethanol; shellac; strong ammonia solution; sulfuric acid - prograf is indicated for use as an adjunct to liver, kidney, heart or lung allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 1 mg - capsule, hard - excipient ingredients: titanium dioxide; croscarmellose sodium; hypromellose; magnesium stearate; lactose monohydrate; gelatin; purified water; butan-1-ol; hyprolose; iron oxide red; industrial methylated spirit; simethicone; lecithin; ethanol; shellac; strong ammonia solution; sulfuric acid - prograf is indicated for use as an adjunct to liver, kidney, heart or lung allograft transplantation in adults and children.

אוסטרליה - אנגלית - Department of Health (Therapeutic Goods Administration)

astellas pharma australia pty ltd - tacrolimus, quantity: 3 mg - capsule - excipient ingredients: hypromellose; ethylcellulose; lactose monohydrate; magnesium stearate; titanium dioxide; iron oxide yellow; iron oxide red; gelatin; sodium lauryl sulfate; hyprolose; butan-1-ol; purified water; industrial methylated spirit; simethicone; lecithin; ethanol; shellac; strong ammonia solution; sulfuric acid - indicated for use as an adjunct to liver, kidney, lung or heart allograft transplantation in adults and children.

ארצות הברית - אנגלית - NLM (National Library of Medicine)

glenmark pharmaceuticals inc., usa - sirolimus (unii: w36zg6ft64) (sirolimus - unii:w36zg6ft64) - sirolimus tablets are indicated for the prophylaxis of organ rejection in patients aged 13 years or older receiving renal transplants. in patients at low-to moderate-immunologic risk , it is recommended that sirolimus tablets be used initially in a regimen with cyclosporine and corticosteroids; cyclosporine should be withdrawn 2 to 4 months after transplantation [see dosage and administration (2.2) ]. in patients at high-immunologic risk (defined as black recipients and/or repeat renal transplant recipients who lost a previous allograft for immunologic reason and/or patients with high panel-reactive antibodies [pra; peak pra level > 80%]), it is recommended that sirolimus tablets be used in combination with cyclosporine and corticosteroids for the first year following transplantation [see dosage and administration (2.3), clinical studies (14.3) ]. cyclosporine withdrawal has not been studied in patients with banff grade 3 acute rejection or vascular rejection prior to cyclosporine withdrawal, those who are dialysis-dependent, those with serum creatinine >4.5 mg/dl, black patients, patients of multi-organ transplants, secondary transplants, or those with high levels of panel-reactive antibodies [see clinical studies (14.2) ]. in patients at high-immunologic risk , the safety and efficacy of sirolimus tablets used in combination with cyclosporine and corticosteroids has not been studied beyond one year; therefore after the first 12 months following transplantation, any adjustments to the immunosuppressive regimen should be considered on the basis of the clinical status of the patient [see clinical studies (14.3) ]. in pediatric patients , the safety and efficacy of sirolimus tablets have not been established in patients <13 years old, or in pediatric (<18 years) renal transplant patients considered at high-immunologic risk [see adverse reactions (6.5), clinical studies (14.6) ]. the safety and efficacy of de novo use of sirolimus tablets without cyclosporine have not been established in renal transplant patients [see warnings and precautions (5.12) ]. the safety and efficacy of conversion from calcineurin inhibitors to sirolimus tablets in maintenance renal transplant patients have not been established [see clinical studies (14.4) ]. sirolimus tablets are indicated for the treatment of patients with lymphangioleiomyomatosis (lam). sirolimus tablets are contraindicated in patients with a hypersensitivity to sirolimus [see warnings and precautions (5.4) ]. risk summary based on animal studies and the mechanism of action, sirolimus can cause fetal harm when administered to a pregnant woman [see data, clinical pharmacology (12.1) ]. there are limited data on the use of sirolimus during pregnancy; however, these data are insufficient to inform a drug-associated risk of adverse developmental outcomes. in animal studies, sirolimus was embryo/fetotoxic in rats at sub-therapeutic doses [see data ]. advise pregnant women of the potential risk to a fetus. the estimated background risk of major birth defects and miscarriage for the indicated population is unknown. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. data animal data sirolimus crossed the placenta and was toxic to the conceptus. in rat embryo-fetal development studies, pregnant rats were administered sirolimus orally during the period of organogenesis (gestational day 6 to 15). sirolimus produced embryo-fetal lethality at 0.5 mg/kg (2.5-fold the clinical dose of 2 mg, on a body surface area basis) and reduced fetal weight at 1 mg/kg (5-fold the clinical dose of 2 mg). the no observed adverse effect level (noael) for fetal toxicity in rats was 0.1 mg/kg (0.5-fold the clinical dose of 2 mg). maternal toxicity (weight loss) was observed at 2 mg/kg (10-fold the clinical dose of 2 mg). the noael for maternal toxicity was 1 mg/kg. in combination with cyclosporine, rats had increased embryo-fetal mortality compared with sirolimus alone. in rabbit embryo-fetal development studies, pregnant rabbits were administered sirolimus orally during the period of organogenesis (gestational day 6 to 18). there were no effects on embryo-fetal development at doses up to 0.05 mg/kg (0.5-fold the clinical dose of 2 mg, on a body surface area basis); however, at doses of 0.05 mg/kg and above, the ability to sustain a successful pregnancy was impaired (i.e., embryo-fetal abortion or early resorption). maternal toxicity (decreased body weight) was observed at 0.05 mg/kg. the noael for maternal toxicity was 0.025 mg/kg (0.25-fold the clinical dose of 2 mg). in a pre- and post-natal development study in rats, pregnant females were dosed during gestation and lactation (gestational day 6 through lactation day 20). an increased incidence of dead pups, resulting in reduced live litter size, occurred at 0.5 mg/kg (2.5-fold the clinical dose of 2 mg/kg on a body surface area basis). at 0.1 mg/kg (0.5-fold the clinical dose of 2 mg), there were no adverse effects on offspring. sirolimus did not cause maternal toxicity or affect developmental parameters in the surviving offspring (morphological development, motor activity, learning, or fertility assessment) at 0.5 mg/kg, the highest dose tested. risk summary it is not known whether sirolimus is present in human milk. there are no data on its effects on the breastfed infant or milk production. the pharmacokinetic and safety profiles of sirolimus in infants are not known. sirolimus is present in the milk of lactating rats. there is potential for serious adverse effects from sirolimus in breastfed infants based on mechanism of action [see clinical pharmacology (12.1)]. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for sirolimus and any potential adverse effects on the breastfed child from sirolimus. contraception females should not be pregnant or become pregnant while receiving sirolimus. advise females of reproductive potential that animal studies have been shown sirolimus to be harmful to the developing fetus. females of reproductive potential are recommended to use highly effective contraceptive method. effective contraception must be initiated before sirolimus therapy, during sirolimus therapy, and for 12 weeks after sirolimus therapy has been stopped [see warnings and precautions (5.15), use in specific populations (8.1) ]. infertility based on clinical findings and findings in animals, male and female fertility may be compromised by the treatment with sirolimus [see adverse reactions (6.7), nonclinical toxicology (13.1) ]. ovarian cysts and menstrual disorders (including amenorrhea and menorrhagia) have been reported in females with the use of sirolimus. azoospermia has been reported in males with the use of sirolimus and has been reversible upon discontinuation of sirolimus in most cases. renal transplant the safety and efficacy of sirolimus in pediatric patients <13 years have not been established.  the safety and efficacy of sirolimus oral solution and sirolimus tablets have been established for prophylaxis of organ rejection in renal transplantation in children ≥13 years judged to be at low- to moderate-immunologic risk. use of sirolimus oral solution and sirolimus tablets in this subpopulation of children ≥ 13 years is supported by evidence from adequate and well-controlled trials of sirolimus oral solution in adults with additional pharmacokinetic data in pediatric renal transplantation patients [see clinical pharmacology (12.3) ]. safety and efficacy information from a controlled clinical trial in pediatric and adolescent (< 18 years of age) renal transplant patients judged to be at high-immunologic risk, defined as a history of one or more acute rejection episodes and/or the presence of chronic allograft nephropathy, do not support the chronic use of sirolimus oral solution or tablets in combination with calcineurin inhibitors and corticosteroids, due to the higher incidence of lipid abnormalities and deterioration of renal function associated with these immunosuppressive regimens compared to calcineurin inhibitors, without increased benefit with respect to acute rejection, graft survival, or patient survival [see clinical studies (14.6) ]. lymphangioleiomyomatosis the safety and efficacy of sirolimus in pediatric patients <18 years have not been established. clinical studies of sirolimus oral solution or tablets did not include sufficient numbers of patients ≥65 years to determine whether they respond differently from younger patients. data pertaining to sirolimus trough concentrations suggest that dose adjustments based upon age in geriatric renal patients are not necessary. differences in responses between the elderly and younger patients have not been identified. in general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, or cardiac function, and of concomitant disease or other drug therapy.  the maintenance dose of sirolimus should be reduced in patients with hepatic impairment [see dosage and administration (2.7), clinical pharmacology (12.3) ]. dosage adjustment is not required in patients with renal impairment [see dosage and administration (2.8), clinical pharmacology (12.3) ].

ארצות הברית - אנגלית - NLM (National Library of Medicine)

novartis pharmaceuticals corporation - everolimus (unii: 9hw64q8g6g) (everolimus - unii:9hw64q8g6g) - everolimus 0.25 mg - zortress is indicated for the prophylaxis of organ rejection in adult patients at low to moderate immunologic risk receiving a kidney transplant [ see clinical studies   (14.1)] . zortress is to be administered in combination with basiliximab induction and concurrently with reduced doses of cyclosporine and with corticosteroids. therapeutic drug monitoring (tdm) of everolimus and cyclosporine is recommended for all patients receiving these products [ see dosage and administration (2.2 , 2.3)] . zortress is indicated for the prophylaxis of allograft rejection in adult patients receiving a liver transplant. zortress is to be administered no earlier than 30 days posttransplant concurrently in combination with reduced doses of tacrolimus and with corticosteroids [ s ee warnings and precautions (5. 5 ) , clinical studies (14.2) ] . tdm of everolimus and tacrolimus is recommended for all patients receiving these products [ s ee dosage and administration (2.3 , 2.5)] . the safety and efficacy of zortress has not been established in the following populations: - kidney transplant patients at high immunologic risk. - recipients of transplanted organs other than kidney and liver [see warnings and precautions (5.7)] . - pediatric patients (less than 18 years). zortress is contraindicated in patients with known hypersensitivity to everolimus, sirolimus, or to components of the drug product.  risk summary based on animal studies and the mechanism of action [see clinical pharmacology (12.1)] , zortress can cause fetal harm when administered to a pregnant woman. there are limited case reports of zortress use in pregnant women; however, these reports are insufficient to inform a drug-associated risk of adverse developmental outcomes. reproductive studies in animals have demonstrated that everolimus was maternally toxic in rabbits and caused embryo-fetal toxicities in rats and rabbits, at exposures near or below those achieved in human transplant patients. advise pregnant women of the potential risk to a fetus. the background risk of major birth defects and miscarriage for the indicated population is unknown; however, in the u.s. general population, the estimated background risk of major birth defects is 2% to 4% and of miscarriage is 15% to 20% of clinically recognized pregnancies. data animal data everolimus crossed the placenta and was toxic to the conceptus. everolimus administered daily to pregnant rats by oral gavage at 0.1 mg/kg (approximately one tenth the exposure in humans administered the lowest starting dose of 0.75 mg twice daily), from before mating through organogenesis, resulted in increased preimplantation loss and embryonic resorptions. these effects occurred in the absence of maternal toxicities. everolimus administered daily by oral gavage to pregnant rabbits during organogenesis resulted in abortions, maternal toxicity and lethality, and increased fetal resorptions. at these doses, exposure to everolimus (auc) was approximately one-tenth-, one-half-, and one- and one-half-fold the exposures in humans administered the starting clinical dose, respectively. in a pre- and post-natal development study in rats, animals were dosed from implantation through lactation. at a dose of 0.1 mg/kg (0.6 mg/m2 ), there were no adverse effects on delivery and lactation or signs of maternal toxicity; however, there were reductions in body weight (up to 9% reduction) and in survival of offspring (~5%). there were no drug-related effects on the developmental parameters (morphological development, motor activity, learning, or fertility assessment) in the offspring. risk summary there is no data regarding the presence of zortress in human milk, the effects on breastfed infants, or the effects on milk production. everolimus and/or its metabolites are readily transferred into milk of lactating rats at a concentration 3.5 times higher than in maternal rat serum. in pre-post-natal and juvenile studies in rats, exposure to everolimus during the postnatal period caused developmental toxicity [see use in specific populations (8.1), nonclinical toxicology (13.2)] . advise lactating women not to breastfeed because of the potential for serious adverse reactions in infants exposed to everolimus. contraception females should not be pregnant or become pregnant while receiving zortress. advise females of reproductive potential that animal studies have been performed showing zortress to be harmful to the mother and developing fetus [see use in specific populations (8.1)] . females of reproductive potential are recommended to use highly effective contraception methods while receiving zortress and up to 8 weeks after treatment has been stopped. infertility females amenorrhea occurred in female patients taking zortress [see adverse reactions (6.2)] . zortress may cause pre-implantation loss in females based on animal data [see nonclinical toxicology (13.1)] . female fertility may be compromised by treatment with zortress. males zortress treatment may impair fertility in males based on human [see warnings and precautions (5.18), adverse reactions (6.2, 6.3)] and animal findings [see nonclinical toxicology (13.1)] . the safe and effective use of zortress in kidney or liver transplant patients younger than 18 years of age has not been established. there is limited clinical experience on the use of zortress in patients of age 65 years or older. there is no evidence to suggest that elderly patients will require a different dosage recommendation from younger adult patients [ s ee c linical pharmacology   ( 12. 5 ) ] . everolimus whole blood trough concentrations should be closely monitored in patients with impaired hepatic function. for patients with mild hepatic impairment (child-pugh class a), the dose should be reduced by approximately one-third of the normally recommended daily dose. for patients with moderate or severe hepatic impairment (child-pugh class b or c), the initial daily dose should be reduced to approximately half of the normally recommended daily dose. further dose adjustment and/or dose titration should be made if a patient’s whole blood trough concentration of everolimus, as measured by an lc/ms/ms assay, is not within the target trough concentration range of 3 to 8 ng/ml [ s ee clinical pharmacology (12. 6 )] . no dose adjustment is needed in patients with renal impairment [ s ee clinical pharmacology (12. 6 ) ] .

ארצות הברית - אנגלית - NLM (National Library of Medicine)

slate run pharmaceuticals, llc - mycophenolate sodium (unii: wx877sqi1g) (mycophenolic acid - unii:hu9dx48n0t) - mycophenolic acid delayed-release tablets are indicated for the prophylaxis of organ rejection in adult patients receiving a kidney transplant. mycophenolic acid delayed-release tablets are indicated for the prophylaxis of organ rejection in pediatric patients 5 years of age and older who are at least 6 months post kidney transplant. mycophenolic acid delayed-release tablets are to be used in combination with cyclosporine and corticosteroids. mycophenolic acid delayed-release tablets and mycophenolate mofetil (mmf) tablets and capsules should not be used interchangeably without physician supervision because the rate of absorption following the administration of these two products is not equivalent. mycophenolic acid delayed-release tablets are contraindicated in patients with a hypersensitivity to mycophenolate sodium, mycophenolic acid (mpa), mycophenolate mofetil, or to any of its excipients. reactions like rash, pruritus, hypotension, and chest pain have been observed in clinical trials and post marketing reports [see adverse reactions ( 6)] . pregnancy exposure registry there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to mycophenolate during pregnancy and those becoming pregnant within 6 weeks of discontinuing mycophenolic acid delayed-release tablets treatment. to report a pregnancy or obtain information about the registry, visit www.mycophenolaterems.com or call 1-800-617-8191. risk summary following oral or intravenous (iv) administration, mmf is metabolized to mycophenolic acid (mpa), the active ingredient in mycophenolic acid delayed-release tablets and the active form of the drug. use of mmf during pregnancy is associated with an increased risk of first trimester pregnancy loss and an increased risk of multiple congenital malformations in multiple organ systems (see human data) . oral administration of mycophenolate to rats and rabbits during the period of organogenesis produced congenital malformations and pregnancy loss at doses less than the recommended clinical dose (0.05 and 1.1 times exposure at the recommended clinical doses in kidney transplant patients for rats and rabbits, respectively) (see animal data) . risks and benefits of mycophenolic acid delayed-release tablets should be discussed with the patient. when appropriate, consider alternative immunosuppressants with less potential for embryo-fetal toxicity. the estimated background risk of pregnancy loss and congenital malformations in organ transplant populations is not clear. in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. data human data a spectrum of congenital malformations (including multiple malformations in individual newborns) has been reported in 23% to 27% of live births in mmf exposed pregnancies, based on published data from pregnancy registries. malformations that have been documented include external ear, eye, and other facial abnormalities, including cleft lip and palate, and anomalies of the distal limbs, heart, esophagus, kidney, and nervous system. based on published data from pregnancy registries, the risk of first trimester pregnancy loss has been reported at 45% to 49% following mmf exposure. animal data in animal reproductive toxicology studies, congenital malformations and pregnancy loss occurred when pregnant rats and rabbits received mycophenolate at dose multiples equivalent to and less than the recommended human dose. oral administration of mycophenolate sodium to pregnant rats from gestational day 7 to day 16 at a dose as low as 1 mg per kg resulted in malformations including anophthalmia, exencephaly, and umbilical hernia. the systemic exposure at this dose represents 0.05 times the clinical exposure at the human dose of 1,440 mg per day of mycophenolic acid delayed-release tablets. oral administration of mycophenolate to pregnant rabbits from gestational day 7 to day 19 resulted in embryofetal lethality and malformations, including ectopia cordis, ectopic kidneys, diaphragmatic hernia, and umbilical hernia at doses equal to or greater than 80 mg per kg per day, in the absence of maternal toxicity. this corresponds to about 1.1 times the recommended clinical dose based on bsa. risk summary there are no data on the presence of mycophenolate in human milk, or the effects on milk production. there are limited data in the national transplantation pregnancy registry on the effects of mycophenolate on a breastfed child (see data) . studies in rats treated with mmf have shown mycophenolic acid to be present in milk. because available data are limited, it is not possible to exclude potential risks to a breastfeeding infant. the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for mycophenolic acid delayed-release tablets and any potential adverse effects on the breastfed infant from mycophenolic acid delayed-release tablets or from the underlying maternal condition. because available data are limited, it is not possible to exclude potential risks to a breastfeeding infant. data limited information is available from the national transplantation pregnancy registry. of seven infants reported by the national transplantation pregnancy registry to have been breastfed while the mother was taking mycophenolate, all were born at 34 to 40 weeks gestation and breastfed for up to 14 months. no adverse events were reported. females of reproductive potential must be made aware of the increased risk of first trimester pregnancy loss and congenital malformations and must be counseled regarding pregnancy prevention and planning. pregnancy planning for female patients taking mycophenolic acid delayed-release tablets who are considering pregnancy, consider alternative immunosuppressants with less potential for embryo-fetal toxicity. risks and benefits of mycophenolic acid delayed-release tablets should be discussed with the patient. pregnancy testing to prevent unplanned exposure during pregnancy, females of reproductive potential should have a serum or urine pregnancy test with a sensitivity of at least 25 miu/ml immediately before starting mycophenolic acid delayed-release tablets. another pregnancy test with the same sensitivity should be done 8 to 10 days later. repeat pregnancy tests should be performed during routine follow-up visits. results of all pregnancy tests should be discussed with the patient. in the event of a positive pregnancy test, consider alternative immunosuppressants with less potential for embryo-fetal toxicity whenever possible. contraception female patients females of reproductive potential taking mycophenolic acid delayed-release tablets must receive contraceptive counseling and use acceptable contraception (see table 5 for acceptable contraception methods). patients must use acceptable birth control during entire mycophenolic acid delayed-release tablets therapy, and for 6 weeks after stopping mycophenolic acid delayed-release tablets, unless the patient chooses abstinence (she chooses to avoid heterosexual intercourse completely). patients should be aware that mycophenolic acid delayed-release tablets reduce blood levels of the hormones in the oral contraceptive pill and could theoretically reduce its effectiveness [see patient counseling information ( 17), drug interactions ( 7.8)] . or or   choose one barrier method   from each column (must   choose two methods) male patients genotoxic effects have been observed in animal studies at exposures exceeding the human therapeutic exposures by approximately 2.5 times. thus, the risk of genotoxic effects on sperm cells cannot be excluded. based on this potential risk, sexually active male patients and/or their female partners are recommended to use effective contraception during treatment of the male patient and for at least 90 days after cessation of treatment. also, based on the potential risk of genotoxic effects, male patients should not donate sperm during treatment with mycophenolic acid delayed-release tablets and for at least 90 days after cessation of treatment [see use in specific populations ( 8.1), nonclinical toxicology ( 13.1), patient counseling information ( 17)] . the safety and effectiveness of mycophenolic acid delayed-release tablets have been established in pediatric kidney transplant patients 5 to 16 years of age who were initiated on mycophenolic acid delayed-release tablets at least 6 months post-transplant. use of mycophenolic acid delayed-release tablets in this age group is supported by evidence from adequate and well-controlled studies of mycophenolic acid delayed-release tablets in a similar population of adult kidney transplant patients with additional pharmacokinetic data in pediatric kidney transplant patients [see dosage and administration ( 2.2, 2.3), clinical pharmacology ( 12.3)] . pediatric doses for patients with bsa<1.19 m 2 cannot be accurately administered using currently available formulations of mycophenolic acid delayed-release tablets. the safety and effectiveness of mycophenolic acid delayed-release tablets in de novo pediatric kidney transplant patients and in pediatric kidney transplant patients below the age of 5 years have not been established. clinical studies of mycophenolic acid delayed-release tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. of the 372 patients treated with mycophenolic acid delayed-release tablets in the clinical trials, 6% (n=21) were 65 years of age and older and 0.3% (n=1) were 75 years of age and older. other reported clinical experience has not identified differences in responses between the elderly and younger patients. in general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.