Mycophenolate (Cellcept)
Mycophenolate Mofetil, Mycophenolic Acid, or sometimes Mycophenolate is a medication that works by suppressing the immune system.
Mycophenolate is useful in treating rheumatic diseases like lupus. Outside of rheumatology, Mycophenolate is used to prevent organ rejection in transplant patients.
Taking Mycophenolate
Mycophenolate is available as oral tablets in 250 and 500 mg doses. The normal dose of Mycophenolate is between 500 and 1500 mg twice per day.
It takes 6 to 12 weeks for the Mycophenolate to start working. It is important for patients starting this medicine to keep taking it as prescribed.
Taking Mycophenolate with food can help minimize possible side effects like nausea and stomach pain.
Important Tests and Risks
Patients taking Mycophenolate should have their blood tested regularly to make sure that the medicine isn’t affecting the blood counts or harming the liver.
Mycophenolate can make it a bit harder for people to fight off infections. People taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
It is important for patients to coordinate with their doctor to stop treatment before any surgery. It can be re-started once things have healed and there’s no sign of infection.
Patients should discuss all vaccinations with their doctor because some (live vaccines) are not advisable to get while taking Mycophenolate.
Science
Mycophenolate (mycophenolic acid) works by preventing certain types of cells from multiplying.
It targets an enzyme in the body called inosine monophosphate dehydrogenase that is important for creating new strands of DNA. By interfering with this process, Mycophenolate makes it difficult for cells to multiply. White blood cells that form part of the body’s immune system are particularly affected by this process.
In people with rheumatic disease, the immune system is attacking the body by mistake. Mycophenolate softens this attack by preventing immune system cells from replicating and making more of themselves. Although suppressing the immune system can make it slightly harder for patients to fight off infections, it can also help stabilize an overactive immune system.
Safety
Mycophenolate is a powerful medicine that requires regular blood tests to monitor for more serious side effects.
Side-effects of Mycophenolate include:
- Nausea & feeling unwell – Some patients feel sick to their stomach or develop diarrhea when they take Mycophenolate. They should tell their doctor if this happens.
- Headaches – Mycophenolate can cause headaches, dizziness, and difficulty sleeping.
- Sores in the mouth
- Rare brain infection – Some patients have very rarely developed a rare brain infection called Progressive Multifocal Leukoencephalopathy while taking Mycophenolate.
- Cancer – When used for long periods of time, Mycophenolate may be associated with a small increased risk of skin or blood cancers.
People taking Mycophenolate should talk to their doctor if they are concerned about any side effects.
Mycophenolate can simply be stopped and does not need to be “weaned off”. Patients should tell their doctor if they stop taking this medicine.
Mycophenolate is not normally used in pregnancy. Patients who become pregnant or are breastfeeding while taking this medicine should tell their doctor.
Patients who should NOT be taking Mycophenolate include:
- Patients who have had a previous reaction to Mycophenolate
- Women who are pregnant, planning on becoming pregnant, or are breast feeding
- Patients with active infections
- Possibly patients with a past history of cancer
Anyone who becomes pregnant while taking Mycophenolate should notify their doctor immediately.
Pregnancy and medicationsPeople taking Mycophenolate should call their doctor if they feel sick and want to stop, or they are concerned about any side effects.
Other reasons to call a doctor while taking Mycophenolate include:
- Nausea or Diarrhea
- Fever or possible infection
- Becoming pregnant or planning pregnancy
- Before getting any vaccinations
- Before any surgery