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Objective To evaluate the effect of mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS) on the blood concentration of mycophenolic acid (MPA) and adverse events in renal transplant recipients at the equivalent biologically effective dose. Methods Clinical data of 106 recipients undergoing living-donor kidney transplantation were retrospectively analyzed. According to the drugs taken after renal transplantation, all recipients were divided into the MMF (M1 group, n=62) and EC-MPS groups (M2 group, n=44). In the M1 group, tacrolimus (FK506) + MMF + prednisone was delivered and FK506 + EC-MPS + prednisone was given in the M2 group. The changes of blood concentration of MPA were analyzed at 1-, 2-, 3-week, 1-, 2- and 3-month after drug administration. The incidence of adverse events and the drug cost were also analyzed. Results The drugs were administered at the same biologically effective dose. At each time point after drug administration, the trough blood concentration of MPA in the M1 group was significantly lower than that in the M2 group (all P<0.05). Compared with the M1 group, the incidence and severity of adverse events were significantly less in the M2 group. The cost of taking MMF in the M1 group was 1 710 Yuan/month, whereas 2 736 Yuan/month for taking EC-MPS in the M2 group. However, the cost of treating drug-induced adverse events in the M1 group was significantly higher than that in the M2 group. Conclusions Patients taking EC-MPS at the same biologically effective dose can maintain higher blood concentration of MPA and suffer from fewer adverse events than their counterparts receiving MMF. [ABSTRACT FROM AUTHOR]