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Tacrolimus + mycophenolate mofetil is a combination of two immunosuppressive agents widely used to prevent acute organ transplant rejection and to treat certain autoimmune diseases such as systemic lupus erythematosus with renal involvement. Tacrolimus is a calcineurin inhibitor that suppresses T-cell activation by inhibiting the phosphatase activity of calcineurin. Mycophenolate mofetil is a prodrug of mycophenolic acid and acts as a selective, reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), thereby blocking de novo guanine nucleotide synthesis in lymphocytes and inhibiting both T- and B-cell proliferation. The combination provides synergistic immunosuppression with reduced risk of nephrotoxicity compared to other regimens[1][2][3][4][5][6][8].
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