Mifamurtide

Synthetic Lipopeptide ImmunomodulatorRx: PrescriptionCompound: Approved

Also known as: CGP-19835A, L-MTP-PE, Mepact, Mifamurtide, MTP-PE, MTP‑PE, Muramyl tripeptide phosphatidylethanolamine

Educational Only — Not medical advice. Consult a qualified clinician before using any peptide.

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Summary

Mifamurtide (muramyl tripeptide phosphatidylethanolamine) is a lipophilic derivative of bacterial muramyl dipeptide used as an adjuvant therapy for resectable high‑grade osteosarcoma.

Mechanism of Action

Activates NOD2 receptors on monocytes/macrophages, triggering NF-κB signaling and cytokine release that enhances anti‑tumor immune responses.

Routes of Administration

IntravenousSubcutaneous

Goals & Uses

  • Adjuvant treatment of high‑grade osteosarcomaOncologyModerate
  • Immunostimulation / macrophage activationImmunologyModerate
  • Prevention of metastatic relapseOncologyModerate
  • Osteosarcoma adjuvant treatmentOncologyHigh
  • Investigational use in other sarcomasOncologyLow

Contraindications

  • Severe active infectionsInfectionModerate
  • Hypersensitivity to mifamurtide or liposomal componentsAllergyHigh
  • Known hypersensitivity to mifamurtide or its excipientsAllergyHigh
  • Concurrent high-dose NSAIDs or corticosteroidsDrug InteractionHigh
  • Concurrent use of cyclosporine or other calcineurin inhibitorsDrug InteractionHigh
  • Active autoimmune or inflammatory disease requiring immunosuppressionDisease StateModerate

Adverse Effects

  • Anemia / thrombocytopeniaHematologicUncommon
  • HeadacheNeurologicCommonPain in the head or upper neck
  • HypotensionCardiovascularUncommonLow blood pressure
  • Fever and chillsConstitutionalCommon
  • Nausea and vomitingGastrointestinalCommon
  • Tachycardia and hypertensionCardiovascularUncommon
  • NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
  • FatigueGeneralCommonLow energy or tiredness
  • Injection‑site reactionsLocalCommon
  • Chills / rigorsSystemicCommon
  • FeverSystemicCommonElevated body temperature

Drug Interactions

  • Immunosuppressants (e.g., corticosteroids, azathioprine)Moderate
  • Corticosteroids (high-dose)High
  • Live vaccinesModerate
  • CyclosporineHigh
  • NSAIDsModerateMay increase renal risk in susceptible patients
  • Doxorubicin / Cisplatin / MethotrexateLow

Population Constraints

  • PregnancyReproductive SafetyRelative
  • Adults over 30 yearsAgeRelative
  • Patients with severe hepatic or renal impairmentOrgan ImpairmentRelative
  • Patients with active infectionsInfectious DiseaseRelative
  • Pregnant or breastfeeding womenReproductiveRelative
  • Children under 2 yearsPediatricRelative
  • Patients ≥2 years old with resectable high‑grade osteosarcomaIndicationAbsolute

Regulatory Status

  • European UnionApprovedApproved: adjuvant treatment of high‑grade osteosarcoma post‑surgeryMarketed as Mepact.
  • United StatesUnapprovedInvestigational; not FDA‑approved.
  • United KingdomApprovedApproved: adjuvant treatment of high‑grade osteosarcomaRegulated under EU framework post‑Brexit.

Approved in the European Union (Mepact) for post‑surgical osteosarcoma; not approved in the United States, where it remains investigational.

Evidence & Sources

No sources recorded yet.

Frequently Asked Questions

What is Mifamurtide?

Mifamurtide (muramyl tripeptide phosphatidylethanolamine) is a lipophilic derivative of bacterial muramyl dipeptide used as an adjuvant therapy for resectable high‑grade osteosarcoma.

What is Mifamurtide used for?

Mifamurtide is educationally associated with: Adjuvant treatment of high‑grade osteosarcoma, Immunostimulation / macrophage activation, Prevention of metastatic relapse, Osteosarcoma adjuvant treatment, Investigational use in other sarcomas. Educational only — not medical advice.

How is Mifamurtide administered?

Recorded routes of administration: Intravenous, Subcutaneous.

What are the potential side effects of Mifamurtide?

Reported adverse effects include: Anemia / thrombocytopenia, Headache, Hypotension, Fever and chills, Nausea and vomiting, Tachycardia and hypertension, Nausea, Fatigue, Injection‑site reactions, Chills / rigors, Fever. This list is not exhaustive — consult a qualified clinician.

Who should avoid Mifamurtide?

Recorded contraindications: Severe active infections, Hypersensitivity to mifamurtide or liposomal components, Known hypersensitivity to mifamurtide or its excipients, Concurrent high-dose NSAIDs or corticosteroids, Concurrent use of cyclosporine or other calcineurin inhibitors, Active autoimmune or inflammatory disease requiring immunosuppression. Consult a qualified clinician before use.