Mycophenolate Mofetil (Oral)

Overview

Mycophenolate Mofetil is an immunosuppressive agent which is prescribed to patients who have recently received organ transplants, such as a kidney, heart, or liver transplant. Mycophenolate Mofetil lowers the number of white blood cells in the bloodstream, which suppresses the body's immune response. Without immunosuppressants, the white blood cells in the body will attack an organ that has been transplanted into the body, which causes harm to the patient and makes the organ unusable. Mycophenolate Mofetil prevents the white blood cells from attacking your transplanted organ.

Mycophenolate Mofetil is only available with a doctor's prescription, and is only available to patients who have recently had an organ transplant. It is known as Cellcept in the United States, and is available in a capsule form, tablet form, or a powder for suspension. It is normally taken orally.

Conditions Treated

  • Organ transplant rejection

Type Of Medicine

  • Immunosuppressant

Side Effects

Mild Side Effects

Some patients who take Mycophenolate Mofetil may experience some mild, unwanted side effects in addition to the therapeutic effects for which the medication was prescribed. These side effects are a result of your body adjusting to the medication, and should usually subside over the course of your treatment. If these side effects do not subside, get worse, or become bothersome, check with your doctor. Your doctor or a health care professional may be able to suggest treatments to ameliorate side effects that are becoming bothersome.

Some patients who take Mycophenolate Mofetil may experience mild gastrointestinal side effects such as:

  • Belching
  • Acid stomach or sour stomach
  • Heartburn
  • Weight loss

Some patients who take Mycophenolate Mofetil may experience dermatological side effects such as:

  • A rash on the skin

Some patients who take Mycophenolate Mofetil may experience muscular side effects such as:

  • A loss or lack of strength

Some patients who take Mycophenolate Mofetil may experience neurological side effects such as:

Serious Side Effects

Some patients who take Mycophenolate Mofetil may experience serious side effects which require medical attention. These side effects can lead to serious health problems or may be symptoms of a serious health problem that has been triggered by the use of Mycophenolate Mofetil. If you experience any of these side effects while using Mycophenolate Mofetil, contact your doctor immediately.

Some patients who take Mycophenolate Mofetil may experience gastrointestinal or eliminatory side effects such as:

  • Pain or cramps in the stomach or the abdomen
  • Pain or bloating in the stomach
  • Pain in the stomach, side, or abdomen that may radiate to the back
  • Indigestion
  • Pain in the bladder
  • Bloody stools
  • Black and tarry stools
  • Blood in the urine
  • Cloudy or bloody urine
  • Darkened urine
  • Constipation
  • Diarrhea that is bloody or watery
  • Decreased urine production or decreased frequency of urination
  • Urination that is painful, difficult, or burns
  • A frequent urge to urinate
  • Increased urine production or increased frequency of urination
  • Dry mouth
  • Increased hunger or increased thirst
  • Loss of appetite
  • Nausea
  • Vomiting
  • Rapid weight gain
  • Unexplained weight loss
  • Unusual weight gain or weight loss

Some patients who take Mycophenolate Mofetil may experience respiratory side effects such as:

  • Chest pain
  • Tightness in the chest
  • A cough or hoarseness in the throat
  • A sore throat
  • Difficulty breathing during exertion or exercise
  • Breathing that is rapid or shallow
  • Breathing that is labored or difficult
  • An odor like fruit on the breath

Some patients who take Mycophenolate Mofetil may experience dermatological side effects such as:

  • Skin that is dry or flushed
  • Pale skin
  • Sores, white spots, or ulcers in the mouth or on the lips
  • Red spots on the skin that look like pinpoints
  • Unusual sweating
  • Night sweats
  • Yellow eyes or skin (jaundice)
  • Bloating or swelling of the face or the extremities such as hands, feet, arms, or lower legs

Some patients who take Mycophenolate Mofetil may experience neurological side effects such as:

  • Tingling in the hands or feet
  • Numbness or tingling in the lips, hands, or feet
  • Burning, itching, crawling, prickling, tingling, "pins and needles," or numbness in areas of the body
  • Confusion
  • Dizziness
  • Dizziness, lightheadedness, or faintness when you get up quickly from a sitting or prone position
  • Drowsiness
  • Lightheadedness
  • Fainting
  • Irritability
  • Nervousness
  • Convulsions
  • Seizures
  • Blurred vision

Some patients who take Mycophenolate Mofetil may experience muscular side effects such as:

  • Pain in the lower back or side
  • Muscle pain or cramps
  • Muscle twitching or spasms (tetany)
  • Muscle cramps in the extremities such as face, arms, hands, legs, or feet
  • Trembling or tremors
  • Back pain
  • Weakness or heaviness in the legs
  • Unusual weakness or tiredness
  • Headaches
  • Severe headaches
  • Tenderness

Some patients who take Mycophenolate Mofetil may experience side effects related to unusual bleeding such as:

  • Bleeding gums
  • Unusual bruising
  • Unusual bleeding
  • Coughing blood or spitting up blood

Some patients who take Mycophenolate Mofetil may experience other side effects such as:

  • A fever or chills
  • A sudden high fever
  • A low-grade fever that lasts for months
  • A general feeling of illness
  • Swollen glands
  • Irregular heartbeat or an irregular pulse
  • An unusually fast or unusually slow pulse
  • Pounding in the ears

Dosage

The dosage and schedule given here is a standard provided by the manufacturer. Your doctor will determine your dose, schedule of dosing, and length of your Mycophenolate Mofetil regimen depending on your needs and condition. Always follow your doctor's directions regarding how much medicine to take, when to take it, and how long to take it for.

Do not take more or less of it than your doctor has prescribed, do not take it more often than your doctor has told you, and do not take it for longer than your doctor directs. An overdose of Mycophenolate Mofetil may lead to increased side effects. Taking too little Mycophenolate Mofetil may lead to your transplanted organ being rejected by your body.

If you miss a dose of Mycophenolate Mofetil, take it as soon as you are able. If it is almost time for the next dose, skip the dose you missed and wait until your next dose. Do not take a double dose of Mycophenolate Mofetil. If you are not sure if it is safe to take your Mycophenolate Mofetil, contact your doctor.

Different brands of Mycophenolate Mofetil capsules or tablets may work differently. Only use the brand of Mycophenolate Mofetil that your doctor has ordered or prescribed.

The average dose of Mycophenolate Mofetil for heart, kidney, or liver transplants:

  • Adult heart transplant patients will take 1.5 grams of Mycophenolate Mofetil twice per day.
  • Children who have had heart transplants will have their use and dose of Mycophenolate Mofetil determined by a doctor.
  • Adult kidney transplant patients will take 1 gram of Mycophenolate Mofetil twice per day.
  • Teenagers and children over 3 months of age who have had kidney transplants will have their dose of Mycophenolate Mofetil determined based on their body size. Patients of this type taking a suspension dose will take 600 mg per square meter of body twice per day. Patients of this type taking tablets and capsules will take 750 mg up to 1 mg twice per day.
  • Children under 3 months of age who have had kidney transplants will have their use and dose of Mycophenolate Mofetil determined by a doctor.
  • Adult patients who have had liver transplants will take 1.5 grams of Mycophenolate Mofetil twice per day.
  • Children who have had liver transplants will have their use and dose determined by a doctor.

If you are using a suspension of Mycophenolate Mofetil, use the oral dispenser provided to you by the pharmacist to measure your dose of Mycophenolate Mofetil. Ask your doctor or pharmacist if you have any questions about proper use of your dispenser.

Mycophenolate Mofetil is most effective when taken on an empty stomach. Take Mycophenolate Mofetil at least 1 hour before a meal or 2 hours after a meal unless your doctor provides alternate directions.

If you use antacids such as Maalox or Mylanta that contain magnesium or aluminum, take these medications 1 hour before you take your dose of Mycophenolate Mofetil or 2 hours after your dose of Mycophenolate Mofetil. Taking these medications at the same time may cause unwanted interactions. Ask your doctor about ideal times to stagger your medications if you have any questions about safe times or ways to take your medication.

Swallow your Mycophenolate Mofetil capsule or tablet whole. Do not crush, chew, break, or open your Mycophenolate Mofetil tablets or capsules. Do not inhale the powder from the capsule and do not allow the oral liquid or powder to touch your skin or eyes. If powder or solution gets on your skin, cleanse your skin thoroughly with soap and water. If the medicine gets in the eyes, flush them out with clean water. If you spill this medication, wipe it up using wet paper towels and carefully dispose of the towels.

Interactions

Drug interactions can change the way your medications work in your body, which can decrease their therapeutic effects, and can increase your risk of side effects from any drug or medication you are taking. Keep a list of all the drugs, medications, and supplements you take on a regular basis, whether they have been prescribed to you by a health care professional or you are taking them over the counter. Your doctor or pharmacist will be able to detect drugs that could interact and advise you about taking your medications safely.

Mycophenolate Mofetil can make hormonal birth control less effective. Hormonal birth control methods include a pill regimen, a patch, or implanted ring. A decrease in the effectiveness of birth control could cause pregnancy; therefore, an additional non-hormonal method of birth control is recommended. Symptoms of birth control that is not working effectively include unusual spotting or breakthrough bleeding. If you are using hormonal birth control while taking Mycophenolate Mofetil, talk to your doctor about your options for additional forms of birth control or medication adjustment.

Mycophenolate Mofetil may interact with drugs that increase the chance of infection or weaken the immune system, especially drugs like natalizumab or rituximab. If you are using other medications that can weaken your immune system, talk to your doctor about the safe use of Mycophenolate Mofetil.

Mycophenolate Mofetil may interact with:

  • Azathioprine
  • Rifampin

Warnings

Progress

Patients using Mycophenolate Mofetil will need to keep regular doctor's appointments. Your doctor will need to do regular blood tests in order to screen for side effects that may not show up as physical symptoms right away, and to make sure that the medication is still working as needed.

Do not stop taking Mycophenolate Mofetil without consulting with your doctor. If you stop taking Mycophenolate Mofetil without your doctor's approval, you may experience a rejection of the organ that has been transplanted into your body. Your doctor will determine the length of your Mycophenolate Mofetil regimen.

Pregnancy

Use of Mycophenolate Mofetil by patients who are pregnant is not recommended. Mycophenolate Mofetil can cause serious birth defects, fetal harm, or com/health/miscarriage/">miscarriage if used by patients who are pregnant during the first 3 months of pregnancy. Your doctor may give you a pregnancy test before you begin a regimen of Mycophenolate Mofetil to ensure that you are not pregnant. If you are using Mycophenolate Mofetil and plan to get pregnant, may become pregnant, or think you may be pregnant while you are taking the medication, tell your doctor as soon as possible.

Mycophenolate Mofetil may cause hormonal birth control to not work as well. If you are using hormonal birth control while taking Mycophenolate Mofetil, plan to use another non-hormonal form of birth control such as contraceptive foam or jelly or a spermicide solution, or a barrier method such as a diaphragm or condom. Talk to your doctor about other birth control solutions for you. You will need to use this method of birth control for at least 1 month before starting Mycophenolate Mofetil and for at least 6 weeks after you take your last dose of Mycophenolate Mofetil, as well as for the entire time you are using the medication.

Skin Cancer

Mycophenolate Mofetil can heighten your risk of getting skin cancer, lymphoma, or cancer of the lymph system. If you have a family history of cancer or other concerns about this risk, talk to your doctor before you begin to take Mycophenolate Mofetil.

Take precautions when exposing your skin to light in order to reduce your risk of skin cancer while taking Mycophenolate Mofetil. If you go outdoors, wear sunblock or sunscreen with a sun protection factor or SPF of at least 15. Wear protective clothing such as hats when going outside. Try to stay out of direct sunlight, especially between the hours of 10 AM and 3 PM, when the sun's rays can be most injurious. Avoid sunlamps, tanning beds, and other forms of light that imitate the sun's rays for therapeutic or atmospheric benefit.

Risk of Infection

Mycophenolate Mofetil may temporarily lower your white blood cell count. Having a lower number of white blood cells in your bloodstream than usual can increase your risk of contracting an infection. You may be more susceptible to viral infections that are serious and are normally very rare, such as herpes, shingles, cytomegalovirus or a CMV infection, polyomavirus associated nephropathy or PVAN, or BK virus-associated nephropathy or BKVAN. You are also at risk for more common infections.

Take special precautions to avoid getting an infection while you are taking Mycophenolate Mofetil. Try to avoid being in close proximity to people who have infections. Symptoms of an infection include a fever or chills, pain in the lower back or side, urination that is difficult or painful, and a cough or hoarseness in the throat. If you experience any of these symptoms while taking Mycophenolate Mofetil or you think you may be getting an infection, talk to your doctor as soon as possible.

Pure Red Cell Aplasia

Mycophenolate Mofetil may trigger a very rare health condition called pure red cell aplasia or PRCA. This is a condition in which the body is no longer to make new red blood cells, which leads to severe anemia. Symptoms of pure red cell aplasia include a fever with a sore throat, unusual bruising or bleeding, pale skin, or unusual weakness or tiredness.

Progressive Multifocal Leukoencephalopathy

Mycophenolate Mofetil can heighten your risk of developing a rare, serious infection of the brain called progressive multifocal leukoencephalopathy, or PML. Symptoms of progressive multifocal leukoencephalopathy include changes in vision, weakness in the legs, clumsiness or loss of coordination, loss of memory, difficulty speaking, and difficulty understanding the speech of others. If you experience any of these symptoms while taking Mycophenolate Mofetil, contact your doctor as soon as possible.

Kidney Disorder

Mycophenolate Mofetil can heighten your risk of contracting BK-virus-associated nephropathy, which may negatively affect the functioning of the kidneys. Patients who have transplanted kidneys are at a heightened risk of kidney failure. Symptoms of kidney problems or kidney failure due to this virus include increased thirst, loss of appetite, blood in the urine or bloody urine, a decreased frequency of urine or amount of urine produced, pain in the lower back or the side, swelling in the extremities such as face, lower legs, or fingers, nausea or vomiting, weight gain, unusual tiredness or weakness, or trouble breathing. If you experience any of these symptoms while taking Mycophenolate Mofetil, contact your doctor as soon as possible and seek medical assistance.

Hepatitis B or C Infection

Patients who have had Hepatitis B or C may experience a recurrence of the infection while taking Mycophenolate Mofetil. Symptoms of Hepatitis B or C include pale stools, dark-colored urine, yellow skin or yellow eyes, nausea, vomiting, loss of appetite, or pain in your upper stomach. If you experience any of these symptoms while taking Mycophenolate Mofetil, contact your doctor as soon as possible.

Immunizations

Mycophenolate Mofetil can decrease the number of white blood cells in your blood, which can lower your body's immune resistance. Check with your doctor before getting any immunizations or vaccinations while you are taking Mycophenolate Mofetil or if you have recently stopped taking Mycophenolate Mofetil. Getting an immunization or vaccination while taking Mycophenolate Mofetil heightens the risk that you will contract the infection that the vaccination is intended to prevent.

Storage

Store Mycophenolate Mofetil in a closed container. Keep it at room temperature, and do not expose to freezing environments, direct light, heat, or moisture. Keep away from children.

Keep your oral suspension of Mycophenolate Mofetil in the refrigerator. If you do not use a suspension of Mycophenolate Mofetil within 60 days, do not use it. Do not keep medication that is out of date. Ask your doctor or pharmacist how to dispose of Mycophenolate Mofetil safely.

Summary

Mycophenolate Mofetil is an immunosuppressant given to heart, kidney, and liver transplant patients after a transplant. It reduces the number of white blood cells in the blood, lowering the immune reaction to the new organ and preventing organ rejection. Mycophenolate Mofetil is also known as Cellcept in the United States.

Mycophenolate Mofetil is only available with a doctor's prescription. It may be taken in a capsule or tablet form, or as an oral suspension. The precise dose and length of time you will take Mycophenolate Mofetil will be determined by your doctor. Always follow your doctor's directions when taking Mycophenolate Mofetil. Do not crush, chew, or break capsules or tablets. Do not inhale powder from Mycophenolate Mofetil. If you get Mycophenolate Mofetil on your skin, wash with soap and water. If you get Mycophenolate Mofetil in your eyes, flush with plain water. If you are taking Mycophenolate Mofetil through an oral suspension, ask your doctor to show you how to use the dispenser correctly.

Take Mycophenolate Mofetil on an empty stomach. It should be taken at least 1 hour before a meal or 2 hours after a meal. If you take an antacid that includes magnesium or aluminum, take your antacids at least 1 hour before your dose of Mycophenolate Mofetil or 2 hours after your dose of Mycophenolate Mofetil.

Keep regular doctor's appointments while taking Mycophenolate Mofetil. Your doctor will need to check on your progress and take regular blood tests to make sure the medication is working correctly and to screen for side effects. Do not stop taking Mycophenolate Mofetil without your doctor's approval, or you risk organ rejection.

Mycophenolate Mofetil can harm a fetus or cause miscarriage if taken within the first 3 months of pregnancy. Your doctor may ask you to take a pregnancy test before beginning Mycophenolate Mofetil. If you think you have become pregnant while taking Mycophenolate Mofetil, consult your doctor immediately. Mycophenolate Mofetil can cause hormonal birth control to not work as well, so make sure you use an additional method of non-hormonal birth control while taking Mycophenolate Mofetil. Watch for symptoms such as breakthrough bleeding which may indicate that your hormonal birth control is not working as well.

Mycophenolate Mofetil can increase your risk of skin cancer or lymphoma. Stay out of direct sunlight and faux sunlight sources such as tanning beds while using Mycophenolate Mofetil. If you do go outdoors, wear protective clothing and use sunscreen or sunblock at that is at least SPF 15.

Mycophenolate Mofetil can increase your risk of contracting an infection. Stay away from individuals who have been sick. Talk to your doctor if you think you have an infection or if you experience a fever or chills, lower back and side pain, difficult or painful urination, and a cough or hoarseness. Talk to your doctor before receiving any vaccinations if you are taking or have recently stopped taking Mycophenolate Mofetil.

Patients taking Mycophenolate Mofetil may experience some mild side effects that do not normally need medical attention. You may experience heartburn or acid stomach, belching, weight loss, a skin rash, insomnia, or weakness. Talk to your doctor if these side effects become bothersome.

Patients taking Mycophenolate Mofetil may experience more serious side effects that require medical attention. Some patients may experience pain, cramps, or bloating in the stomach, side, or abdomen that may radiate to the back, bladder pain, indigestion, bloody or black and tarry stools, bloody or dark urine, constipation or diarrhea, difficult or painful urination, decreased or increased urination, dry mouth or increased thirst, decreased or increased appetite, nausea or vomiting, or unusual weight gain or loss. Some patients may experience difficulty breathing, a sore throat, or a fruitlike odor on the breath. Some patients may experience night sweats, jaundice, bloating or swelling of the face or extremities, skin that is dry, pale, or flushed, sores or ulcers on the mouth or lips, or pinpoint red spots on the skin. Some patients may experience tingling or numbness, confusion or dizziness, lightheadedness, fainting, mood changes, or seizures. Some patients may experience muscle cramps, pain, weakness, tenderness, or tremors. Some patients may experience unusual bleeding or bruising, or the coughing up of blood. Some patients may experience a fever or chills that may last for a long time, a general feeling of illness, swollen glands, or a pulse that is fast, slow, or irregular. If you experience any of these symptoms, talk to your doctor or seek medical attention. Do not stop taking Mycophenolate Mofetil unless under your doctor's orders.