Mycophenolate (Intravenous)

Overview

The immunosuppressive agent mycophenolate is an injection administered along with other medicines as a preventative measure of organ transplant rejection. This drug acts to suppress the natural immunity agents found in the body's system in an effort to prevent the rejection of a transplanted organ.

The rejection of a new organ is caused by the white blood cells working to fight the unknown organ; this drug works to prevent the white blood cells from causing organ rejection.

This medication is typically administered prior to an organ transplant and in every circumstance will be administered by a doctor or another healthcare professional in a hospital setting. While in the hospital recovering from the organ transplant, patients will want to stay in close communication with their doctors and medical teams in order to avoid any complications following their organ transplant.

Patients who are of childbearing age will need to undergo a pregnancy test prior to taking this medication. Furthermore, for one month prior to their procedure, while they are taking this medication, and for at least six weeks following the stoppage of the mycophenolate course of treatment, a barrier method of contraception will be necessary.

Because this medication alters the patient's white blood count and how these cells behave, it is important that they avoid infection. Patients are encouraged to avoid people who are suffering from an infection and to notify their doctor immediately should they come into contact with anyone who has an infection.

Following the intravenous course of treatment with mycophenolate, your doctor will likely transition you to a tablet form that you can continue taking at home in order to avoid your body rejecting the new organ.

Mycophenolate comes in this dosage delivery method:

  • Powder for Solution

Conditions Treated

  • Possible rejection of transplanted organs

Type of Medicine

  • Immunosuppressive agent

Side Effects

The use of mycophenolate may cause a number of unwanted side effects in addition to its desired outcomes. Patients are advised to review the list of side effects below and familiarize themselves with what to do should they occur. As this medication is given as part of an organ transplant procedure, the patient will be in the hospital with a full medical team close at hand. Should any of the symptoms listed below occur, it is advisable to inform a member of the healthcare team right away. Certain symptoms may dissipate on their own without further medical attention, another group with which patients and their caregivers should be familiar.

Notify one of the medical staff right away if any of the following occur:

More likely:

  • Blood in the urine
  • Increased cough
  • Painful or difficult urination
  • Coughing or hoarseness
  • Swelling of the feet or lower legs
  • Lower back or side pain
  • Fever or chills
  • Shortness of breath
  • Chest pain or discomfort

Less likely:

  • Abdominal or stomach pain
  • Trembling or shaking of the hands or feet
  • Bloody vomit
  • Red, inflamed, or bleeding gums
  • Irregular heartbeat
  • White patches on the mouth, tongue, or throat
  • Muscle aches or pain
  • Joint pain
  • Sores inside the mouth
  • Enlarged gums
  • Unexplained bleeding or bruising
  • Black, tarry stools

An unknown incidence of occurrence:

  • Unexplained tiredness or weakness
  • Blue lips, fingernails, or skin
  • Stools that float, and are foul smelling
  • Chronic or occasional diarrhea
  • Sore throats
  • Confusion
  • Night sweats
  • Coughing or spitting up blood
  • Loss of coordination
  • Difficulty speaking or understanding what others say
  • Heart murmurs
  • Drowsiness
  • Abdominal or stomach distention
  • Headaches
  • A general feeling of illness or nausea
  • Irregular, fast or slow, or shallow breathing
  • Dizziness
  • Memory loss
  • Difficult or troubled breathing
  • Severe headaches
  • Convulsions
  • Stiff neck or back
  • Clumsiness
  • Sudden high fever or low-grade fever for months
  • Blurred vision
  • Vision changes
  • Back pain
  • Weakness in the legs

While in the hospital following the organ transplant, the patient may experience certain side effects that will likely dissipate on their own without further medical attention. However, due to the serious nature of an organ transplant procedure, patients are advised to let a member of their medical team know if any of these symptoms occur:

More likely:

  • Constipation
  • Stomach pain
  • Heartburn
  • Weakness
  • Vomiting
  • Nausea
  • Diarrhea

Less likely:

  • Trouble sleeping
  • Acne
  • Skin rashes

While this listing is comprehensive in nature, it is possible that the patient may experience certain side effects that are not listed here. Due to the serious nature of organ transplantation procedures, it is advised that a member of the medical team is informed of any significant reactions.

Dosage

Due to the nature of organ transplantation, this drug is administered in a hospital setting by a nurse or another member of the patient's medical team. Mycophenolate is administered intravenously. Following a certain number of doses, the prescribing physician will transition the patient to an oral version of the medication that they will continue to take during their recovery in order to avoid rejection of the new organ.

Major Drug Interactions:

The use of mycophenolate is contraindicated for use with a number of other medications. If you are taking any of the drugs listed below, your doctor may change the medications that you are taking as these should not be used together:

  • Activated Charcoal
  • Pantoprazole
  • Colesevelam
  • Norfloxacin
  • Dexlansoprazole
  • Rifampin
  • Metronidazole
  • Esomeprazole
  • Omeprazole
  • Colestipol
  • Rabeprazole
  • Cholestyramine
  • Lansoprazole

Using any of the following drugs that are listed below concurrently with mycophenolate may increase the risk of unwanted side effects occurring. If it is deemed that the best course of treatment is to take mycophenolate concurrently with one or more of the drugs listed below, your doctor may change the way that one or both are taken:

  • Norgestrel
  • Cyclosporine
  • Norethindrone
  • Dienogest
  • Mestranol
  • Estradiol Cypionate
  • Levonorgestrel
  • Ethinyl Estradiol
  • Valacyclovir
  • Etonogestrel
  • Acyclovir
  • Medroxyprogesterone Acetate
  • Estradiol Valerate
  • Norelgestromin
  • Drospirenone
  • Norgestimate
  • Desogestrel
  • Sevelamer
  • Ciprofloxacin
  • Ethynodiol Diacetate

The use of certain substances such as tobacco products or the regular intake of alcohol should be discussed with your physician prior to the organ transplant operation as these habits may affect your overall health and how your body reacts to certain medications.

The use of mycophenolate by patients who have certain other medical conditions may cause a worsening of that condition or the treatment of such may be complicated by taking this medication:

  • Kelley-Seegmiller syndrome
  • Stomach ulcers or bleeding
  • Bone marrow problems
  • Lesch-Nyhan syndrome
  • Hepatitis B or C infection
  • Kidney disease
  • Infection

Warnings

Mycophenolate is taken as part of an organ transplant procedure and the patient will be required to undergo a substantial amount of diagnostic testing prior to and following their operation. The prescribing physician will likely order follow-up testing after the patient has been discharged from the hospital and it is important that all appointments are kept and that testing is undergone as scheduled.

Patients who are of childbearing age should not use this medication as it has been proven to cause miscarriage or harm to the developing fetus during the first trimester of pregnancy. Women of childbearing age will be given a pregnancy test prior to their use of this drug. Patients are also encouraged to utilize an additional form of contraception while taking this drug as the hormonal birth control that may be using may not be effective when taking concurrently with this medication.

A barrier form of contraception is advised, such as the use of a diaphragm, IUD, or condom together with a contraceptive jelly or foam. Patients who have any concerns regarding these changes to their contraceptive methods should discuss them thoroughly with their doctor prior to the start of their course of treatment. Patients are advised to adopt this method of contraception for at least one month prior to the start of their course of treatment, throughout the entire time they are taking the medication, and for a period of at least 6 weeks following the conclusion of the treatment.

As this medication is given as part of an organ transplant procedure, the patient may not feel physically up to engaging in physical activity following their operation, but it is still advised to have a strategy in place for when sexual relations are resumed. Should you become pregnant while taking this medication, notify your doctor immediately.

When treated with mycophenolate it is possible that the patient's white blood cell count will decrease substantially in order to prevent the cells from fighting against the new organ and rejecting it. This can also cause the patient to be more susceptible to infection. It is vitally important that any signs of infection such as hoarseness, lower back and side pain, coughing, fever, difficulty urinating, and chills are discussed with the prescribing doctor or a member of the medical team immediately. Notify your doctor immediately if you come into contact with someone who is suffering from an infection.

It is possible that patients who are being treated with mycophenolate can develop a condition called pure red cell aplasia, which is also referred to as PRCA. A rare condition, PRCA causes severe anemia in patients whose body is not able to produce healthy red blood cells due to their medication. If you are taking mycophenolate and experience a sore throat, paleness, unexplained bruising or bleeding, weakness, or unexplained fatigue, or fever, contact a member of your medical team immediately.

Patients who are taking mycophenolate are advised to be aware of the possibility of developing a rare brain infection that can become very serious very quickly. This condition is known as progressive multifocal leukoencephalopathy or PML. Alert your doctor or a member of your medical team immediately if you suffer from any of the following symptoms: weakness in the legs, trouble speaking or understanding others, changes in your vision, problems with coordination, or clumsiness.

Other conditions that can arise due to the use of mycophenolate are:

  • BK virus-associated nephropathy (BKVAN) which can cause complications that make the transplanted kidney fail
  • Shingles
  • Polyomavirus-associated nephropathy (PVAN)
  • Herpes
  • Cytomegalovirus (CMV) infection

Notify your doctor or a member immediately if you experience:

  • Bloody urine
  • Unexplained tiredness or weakness
  • Increased thirst
  • Swelling of the face, fingers, or lower legs
  • Lower back or side pain
  • Nausea
  • Loss of appetite
  • Vomiting
  • Difficulty breathing
  • Unexplained weight gain
  • A decreased frequency or amount of urine

Taking this medication can lead to a hepatitis B or hepatitis C infection in some cases. Alert your doctor immediately if you experience any of the following:

  • Nausea
  • Dark-colored urine or pale stools
  • Loss of appetite
  • Vomiting
  • Yellow skin or eyes
  • Pain in the upper stomach

Patients who are recovering from their transplant and receiving mycophenolate should avoid receiving any type of vaccination or immunization. If for some reason you are in need of a vaccination, speak with your doctor prior to having one administered. This remains true for patients who have stopped taking this medication recently. This medication and its effect on white blood cells reducing your system's immunity and makes you more susceptible to becoming ill from the vaccine.

If you are taking this medication you should be aware of the increased likelihood of lymphoma and other cancers that it can cause. Patients should thoroughly discuss their concerns with their doctor prior to their transplantation and the use of this injection.

Mycophenolate will make your skin sensitive to the sun. Patients who have been recently treated with this medication, or are currently being treated with it should avoid the brightest hours of the day, between 10 am and 3 pm and remain indoors or in a shaded area. Do not use any type of artificial tanning products such as sunlamps after you have been treated with this medication.

If you must be out of doors during the brightest hours of the day, be sure to utilized sun protection of at least 15 SPF and cover your body with light-colored and loose clothing. Wear a sun hat with a broad rim any time that you will be out of doors for longer than a few minutes during daytime hours.

Storage

This medication is administered by a doctor or another member of the patient's medical team at the hospital. As it is not ever self-administered, there is no need to store the drug at home.

Summary

The immunosuppressive agent mycophenolate is an injection that is administered along with other medicines as a preventative measure of organ transplant rejection. This drug acts to suppress the natural immunity agents that are found in the body's system in an effort to prevent the rejection of a transplanted organ.

The rejection of a new organ is caused by the white blood cells working to fight the unknown organ; this drug works to prevent the white blood cells from causing organ rejection.

This medication is typically administered prior to an organ transplant and in every circumstance will be administered by a doctor or another healthcare professional in a hospital setting.

Patients who have recently received a transplant will continue taking this medication in order to prevent rejection of the new organ. After a sufficient period of time, your doctor will transition your medication to a tablet form that you will be able to take after your discharge from the hospital.

This medication can cause serious medical conditions and patients must remain vigilant in notifying their medical team of any side effects or symptoms that they experience, especially those listed above.