Mycophenolate Sodium (Oral)

The use of mycophenolate sodium, an immune suppressant agent, and other drugs during a kidney or other organ transplants helps to suppress the body's white blood cells and prevent them from attacking the new organ.

Overview

The use of mycophenolate sodium, an immune suppressant agent, and other drugs during a kidney or other organ transplant helps to suppress the body's white blood cells and prevent them from attacking the new organ. The risk of the body rejecting the new organ can be quite high and can cause the operation to be unsuccessful. The prescription medication called mycophenolate sodium is an effective preventative measure that allows the new kidney to be accepted by the body.

This medication should be taken with a high level of caution by women of childbearing age. Mycophenolate sodium can cause serious harm to the developing fetus during the first trimester and patients must take care to not become pregnant while taking this medication. If a patient does become pregnant while taking this medication, it is imperative that they notify their doctor immediately.

This medication is typically taken once the transplant has been completed and the patient has been discharged from the hospital. There is a high risk of other medical complications while taking this medication, and patients must remain in active communication with their doctor and other members of their medical team.

Due to the possibility of developing many serious medical conditions while taking mycophenolate sodium, it is imperative that patients and their caregivers familiarize themselves with the signs and symptoms of these conditions and know what action to take should they occur.

Do not stop taking this medication or alter the way in which you take it in any way without first discussing such alterations with your doctor beforehand.

The use of this medication can increase the likelihood of developing certain types of cancer and patients should discuss such risks with their medical team prior to the start of their course of treatment.

Mycophenolate sodium comes in the following method of dosage delivery:

  • Enteric Coated Tablet

Condition(s) Treated

  • Rejection of transplanted kidneys

Type of Medicine

  • Immune Suppressant

Side Effects

Similar to most medications, mycophenolate sodium can cause unwanted side effects in addition to performing in the desired manner. There are several types of side effects, from those that require immediate attention and may be a sign of a more serious problem, to those that typically dissipate on their own without further medical attention. Due to the fact that mycophenolate sodium is taken following or organ transplant, it is advisable to discuss any and all reactions, side effects, and symptoms that occur while taking this medication.

Patients and their caregivers are encouraged to learn the difference between the two categories, however, as they will be given this medication following a kidney transplant, it is advisable that they inform a member of their medical team of any negative reactions that they experience while taking mycophenolate sodium.

Notify your doctor right away if you experience any of these side effects or symptoms:

More likely:

  • Stomach pain or abdominal cramps
  • Unusual tiredness or weakness
  • Bladder pain
  • Trouble breathing at rest or with exertion
  • Swelling of the face or extremities, or other bloating
  • Tightness in the chest
  • Blurred vision
  • Swollen glands
  • Bone pain
  • Sweating
  • Chest pain
  • Sores, ulcers, or white spots on the lips or in the mouth
  • Confusion
  • Sneezing
  • Convulsions
  • Red, tender, or oozing skin at the incision
  • A decrease in the amount of urine
  • Pinpoint red spots on the skin
  • Depression
  • Painful cold sores or blisters on the lips
  • Dizziness
  • Lightheadedness
  • Numbness and tingling around the mouth, fingertips, or extremities
  • Dry mouth
  • Nervousness
  • Fainting
  • Muscle weakness
  • Fever or chills
  • Muscle cramps in the extremities or face
  • Frequent urge to urinate
  • Lower back, side, or stomach pain
  • Headaches
  • Loss of consciousness
  • Increase in heart rate
  • Joint pain, stiffness, or swelling
  • Increased hunger
  • Weakness or heaviness of the legs
  • Increased urination
  • Increased thirst
  • Loss of appetite
  • Increased blood pressure
  • Loss of voice
  • Incoherent speech
  • Metallic taste
  • Fruit-like breath odor
  • Muscle spasms or twitching
  • Flushed, dry skin
  • Nausea or vomiting
  • Fast, pounding, or irregular heartbeat or pulse
  • Noisy, rattling breathing
  • Ear congestion
  • Painful blisters on the trunk of the body
  • Drowsiness
  • Pale skin
  • Difficult, burning, or painful urination
  • Rapid breathing
  • Decreased frequency or amount of urine
  • A runny nose
  • Coughing
  • Sore throats
  • Constipation
  • Sunken eyes
  • Cloudy urine
  • Swelling
  • Burning or stinging of the skin
  • Thirst
  • Body aches or pain
  • Tremor
  • Blood in the urine or stools
  • Unusual bleeding or bruising
  • Bleeding gums
  • Unusual weight gain or loss
  • Black, tarry stools

The next group of side effects will typically dissipate on their own without any further medical attention, however, as this medication is given following an organ transplant procedure, it is advisable that patients or their caregivers notify their doctors of all side effects even if they appear to be mild:

More likely:

  • Acid or sour stomach
  • Difficulty sleeping
  • Back pain
  • Sore mouth or tongue
  • Bleeding gums
  • Shakiness in the legs, arms, hands, or feet
  • Bruising
  • Pimples
  • Difficulty moving
  • Pain or tenderness around the eyes and cheekbones
  • Facial hair growth in females
  • Muscle pains or stiffness
  • Full or round face, neck, or trunk
  • Loss of sexual desire or ability
  • Increased hair growth, especially on the face
  • Itching skin
  • Indigestion
  • White patches in the mouth or on the tongue
  • Irritation in the mouth
  • Loose stools
  • Increased thirst or urination
  • Menstrual irregularities
  • Heartburn
  • Pain
  • Full feeling
  • Passing gas
  • Excess air or gas in the stomach or intestines
  • Redness and swelling of the gums
  • Diarrhea
  • Sleeplessness
  • Blemishes on the skin
  • Stomach discomfort or upset
  • Belching
  • Upper abdominal or stomach pain
  • Anxiety
  • Irritability

It is possible that you may experience some unwanted side effects that are not listed here; in such instances, patients are advised to inform their doctors of any symptoms that occur that do not dissipate on their own or become worse over time. Due to the serious nature of the condition being treated by this medication, it is advisable that your doctor is informed of all side effects that occur. It is always best practice to err on the side of caution following an organ transplant and maintain a proactive manner of communication with one's doctor and medical care team.

Dosage

Patients must take this medication exactly as it is prescribed because taking too much can cause unwanted and potentially serious complications while taking too little can cause the white blood cells to attack the newly transplanted organ. The dosage guidelines that are outlined below reflect the typical manner in which mycophenolate sodium is prescribed; you may receive different guidelines from your doctor, and it is important that you follow them.

Do not change the way in which you take this medication without first discussing those alterations with your doctor.

Patients are advised to take this medication without food, scheduling their dosage for at least two hours after eating, or one hour prior to eating. The tablet is delayed-release and must be swallowed whole without breaking or crushing; do not chew this medication.

Adults are advised to take a dosage equalling 720 milligrams twice each day.

This medication may also be taken by children who are over the age of five; their dosage guidelines are the same as those of teenagers. Depending on the weight of the child or teenager, the dose will equal 400 milligrams for each unit twice per day to start and may increase to the dosage to 720 milligrams per unit also taken twice a day.

In children under the age of five, the doctor or pediatrician will determine the proper dosage on a case by case basis.

Major Drug Interactions

The following list of medicines aims to be comprehensive, it is possible that some patients may experience some side effects from taking other drugs that are not listed here. Due to the serious nature of the condition that this medication treats, it is advised that patients inform their doctors of all side effects, reactions, and symptoms that they experience.

Similar to most other medications, mycophenolate sodium is contraindicated for use with certain drugs. It is important to inform your doctor and medical team of all medications that you are taking including both prescription and non-prescription medications, herbal remedies and all vitamin and mineral supplements. If you are taking any of the following or have recently received one of these vaccines, your doctor may opt to utilize an alternative medication. There are other drugs that may increase the risk of certain side effects and in such cases, your doctor may alter the way that you take one or both drugs.

This list is comprehensive in nature, however, it focuses on the medications that present the most severe problem. Prior to your operation for the organ transplant, go over every drug that you are currently taking, and those that you have recently stopped taking in a comprehensive manner with your doctor and medical team.

Mycophenolate sodium should not be used with the following medications:

  • Activated Charcoal
  • Varicella Virus Vaccine
  • Adenovirus Vaccine Type 4, Live
  • Rubella Virus Vaccine, Live
  • Smallpox Vaccine
  • Rifampin
  • Aluminum Hydroxide
  • Omeprazole
  • Azathioprine
  • Bacillus of Calmette and Guerin Vaccine, Live
  • Mumps Virus Vaccine, Live
  • Colesevelam
  • Mercaptopurine
  • Cyclosporine
  • Magnesium Oxide
  • Dihydroxyaluminum Aminoacetate
  • Magnesium Carbonate
  • Influenza Virus Vaccine, Live
  • Magaldrate
  • Yellow Fever Vaccine
  • Magnesium Hydroxide
  • Dihydroxyaluminum Sodium Carbonate
  • Measles Virus Vaccine, Live
  • Dexlansoprazole
  • Metronidazole
  • Colestipol
  • Norfloxacin
  • Cholestyramine
  • Poliovirus Vaccine, Live
  • Aluminum Phosphate
  • Rotavirus Vaccine, Live
  • Aluminum Carbonate, Basic
  • Typhoid Vaccine
  • Adenovirus Vaccine Type 7, Live

Use of the drugs on the following list may increase your chance of experiencing unwanted side effects. If it is deemed that taking one of these medications concurrently with mycophenolate sodium is the best course of treatment, your doctor may alter the way that you take one or both of the medicines:

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

Your doctor and health team should be aware of all medical conditions from which you suffer. Patients who have any of the following conditions may experience complications or other issues while taking mycophenolate sodium:

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

Warnings

Patients who are taking this medication will be required to keep regular follow-up appointments and also undergo all diagnostic testing as scheduled. This is necessary in order to monitor the effectiveness of the mycophenolate sodium treatment and to detect any possibly harmful side effects.

This medication should not be used by women who are pregnant or who may become pregnant in the near future. Women of childbearing age will be required to undergo a pregnancy prior to the start of their mycophenolate sodium course of treatment and again after they have taken the medication for a period of eight - 10 days. Patients should also be aware that their hormonal birth control method may not be effective while taking this medication.

Women are advised to utilize a barrier method of contraception prior to taking this medication and through the time until they have stopped taking it until their doctor finds it safe to revert back to hormonal birth control. Additionally, such methods such be used for at least six weeks following the conclusion of the course of treatment. These barrier methods of birth control should be thoroughly discussed and implemented prior to the start of the course of treatment.

This medication can increase the likelihood of a number of cancers, including lymphoma and skin cancer. Patients must take a proactive approach to skin care and avoid the sun during peak daylight hours from 10 am to 3 pm. If it is necessary to be out of doors for an extended period of time, an SPF with a factor of at least 15 should be used. Light colored and loose-fitting clothing should be worn. Avoid using sunlamps and tanning beds while taking this medication.

Because this medication can lower the white blood cell count on a temporary basis of patients who are taking it, it is important that patients avoid infection and limit or completely curtail all interaction with people who are suffering from an infection. Be aware of the sign of infection and notify your physician immediately if you experience any of the following:

  • Painful or difficult urination
  • Fever
  • Side pain
  • Coughing or hoarseness
  • Lower back pain
  • Chills

While taking mycophenolate sodium patients can experience a higher risk of becoming afflicted with the rare brain condition that is known as progressive multifocal leukoencephalopathy, or PML. Notify your doctor immediately if you experience any of the following symptoms as this condition can be very debilitating:

  • Clumsiness
  • Vision changes
  • Memory loss
  • Weakness in the legs
  • Difficulty speaking or understanding what others say
  • Loss of coordination

The likelihood of contracting any of the following viral infections will increase while taking this medication, patients and their caregivers should be aware of the following conditions, their signs and symptoms, and what to do should they occur:

  • BK virus-associated nephropathy (BKVAN) a condition that can lead to the transplanted kidney failure
  • Shingles
  • Cytomegalovirus (CMV) infection which can cause serious blood and tissue infections
  • Herpes
  • Polyomavirus-associated nephropathy (PVAN)

Any patient that experiences the symptoms related to the above conditions should contact their doctor immediately:

  • Unexplained tiredness or weakness
  • Fever
  • Fingers, or lower legs that are swollen
  • Loss of appetite
  • Sore throats
  • Side pain
  • Unexplained weight gain
  • Painful cold sores or blisters
  • Nausea
  • Swelling of the face
  • Lower back pain
  • Trouble breathing
  • Increased thirst
  • Vomiting
  • A decreased frequency or amount of urine
  • Bloody urine

Taking this medication can cause hepatitis B and hepatitis C to reactivate. Patients who experience any of the following symptoms must contact their doctor or another member of their medical team immediately:

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

The use of mycophenolate sodium can lead to a condition known as pure red cell aplasia or PRCA. PRCA is an extremely rare condition that causes changes in the body's production of red blood cells. This, in turn, will cause the patient to develop severe anemia. Anytime you experience unexplained weakness or fatigue, excessive bruising and bleeding, a pale affect, sore throats and hoarseness, and chills and fever it is important to contact your doctor immediately.

Patients must first consult with their physician prior to undergoing any immunizations or vaccines after taking this medication.

Patients cannot stop taking this drug, or alter the way in which they take it without first consulting with their doctor. At the conclusion of the course of treatment, your doctor will slowly transition you off of the drug in such a manner as to minimize the occurrence of any unwanted side effects.

Storage

It is always advised to keep all medications in their original packaging. Keep mycophenolate sodium in a low-moisture environment where it is not exposed to direct light or sunlight. Do not expose it to extreme heat or cold; do not allow it to freeze.

Store this and all medications out of the reach of small children and pets.

If at the conclusion of your course of treatment you have any unused, excess, or expired medication, be sure to dispose of it in a safe and appropriate manner.

Patients who are unsure about the best way to safely dispose of this medication should confer with their pharmacist or prescribing physician for further medical advice.

Summary

The use of mycophenolate sodium, an immune suppressant agent, and other drugs during a kidney or other organ transplant helps to suppress the body's white blood cells and prevent them from attacking the new organ. The risk of the body rejecting the new organ can be quite high and can cause the operation to be unsuccessful. The prescription medication called mycophenolate sodium is an effective preventative measure that allows the new kidney to be accepted by the body.

This medication is typically taken once the transplant has been completed and the patient has been discharged from the hospital. There is a high risk of other medical complications while taking this medication, and patients must remain in active communication with their doctor and other members of their medical team.

Do not stop taking this medication without the direction of your physician. When you reach the conclusion of your course of treatment, your doctor will work with you to decrease the amount of medication that you take and taper it off in such a manner as to minimize the occurrence of unwanted side effects.