Mycophenolate (and mycophenolic acid)

Mycophenolate is part of a group of medicines called immunosuppressants. They work by reducing the inflammatory action of your disease. For it to work well, this medicine should be taken as prescribed.  Do not be discouraged if results are not immediate; it usually takes several weeks for your condition to improve.

Please note that mycophenolate does not help everyone who takes it.

How do I take mycophenolate?

Mycophenolate is usually taken twice a day. Capsules and tablets should be taken with a mouthful of water and should then be swallowed whole. The coated tablets should also be swallowed whole but the oral suspension should be taken with the oral dispenser provided and thrown away after two months. Avoid skin contact with the suspension.

Mycophenolate comes as 250mg capsules and 500mg tablets. It is also available as a coated tablet version called Myfortic® and as an oral suspension (Cellcept®). Ensure you always take the same brand of mycophenolate unless it is an informed change introduced by your doctor. Your doctor will prescribe the appropriate dose for you and will adjust the dose accordingly to achieve the best result.

 

Can I carry on taking my other medications?

Due to the potential risk of the drug interacting with other medicines, you should inform your doctor and/or pharmacist about any medication you are currently taking, or any new medicines you have been prescribed. This includes any medications bought from the pharmacy without a prescription as well as herbal and complementary medicines (e.g. St. John’s Wort).  To ensure you remember everything, it may be helpful to bring a list of current medications with you when you see the doctor, nurse or pharmacist. You should also inform us if you are allergic to mycophenolate or any other medication. Avoid antacids containing magnesium and/or aluminium and iron supplements.

 

What else do I need to be aware of before taking mycophenolate?

Previous medical issues

Before starting mycophenolate, you should tell the doctor, nurse or pharmacist if you have any kidney or liver problems, skin disorders, gastrointestinal disease or cancer. You should also inform us if you have a weak immune system or tend to catch infections easily.

 

Pregnancy, contraception and breast-feeding

Mycophenolate can cause birth defects and miscarriages.  

Due to a potential risk to the foetus, do not take mycophenolate if you might be pregnant, are breastfeeding or looking to start a family. You must tell your doctor immediately if you think that you might be pregnant, or if you are planning on having a baby. Women of child bearing potential should use effective contraception (two reliable methods at the same time) whilst on mycophenolate, and for six weeks after stopping the medicine. Before starting mycophenolate, women should also have a pregnancy test about eight to ten days before treatment, followed by a second test immediately before treatment starts. Further pregnancy tests are recommended during treatment, for example, in cases where you have missed taking your contraception.

Mycophenolate passes into breast milk therefore inform your doctor if you are breast-feeding and on treatment and discontinue breast-feeding pending further advice. Men taking mycophenolate are advised not to father a child whilst on mycophenolate. We recommend that either the male patient or his female partner use reliable contraception during mycophenolate treatment and for at least 90 days after stopping treatment (even if they have had a vasectomy). If you think that your partner might be pregnant, talk to your doctor immediately.

It is important you do not stop taking mycophenolate without speaking to your doctor first.

 

Alcohol intake

Both mycophenolate and alcohol can affect the liver. Men and women are advised not to drink more than 14 units of alcohol per week, spread evenly over three or more days, on a regular basis. 14 units is equivalent to six pints of average-strength beer or 10 small glasses of low-strength wine.

 

Food preparation

There are some reports of bacteria (germs) found in food that may cause a problem to those who are less able to fight infections. Your body’s resistance to infection can be reduced while you 

are taking mycophenolate. Cooked chilled foods should therefore be reheated thoroughly, and salads washed well; avoid ready-prepared supermarket salads. Do not eat soft cheese made from unpasteurised milk.

 

Viral infections and vaccinations

As mycophenolate reduces the ability of your immune system to fight infections, you may be more likely to catch infections of the skin, mouth, stomach and intestines, lungs and urinary tract. You should report any symptoms of infection which last for more than three days to your doctor (for example a sore throat, cough or fever).

If you are taking mycophenolate and have never had chickenpox, you may be at risk of severe infection from the virus which causes chickenpox and shingles. Contact your doctor or nurse immediately if you come into close contact with someone who has either of these conditions, as you may need special treatment.

You should also ask your doctor or pharmacist before having any vaccinations.

 

Sun exposure

Take care to avoid too much sun (including sun beds) whilst taking this medicine and use a sunscreen with a high protection factor e.g. SPF 50.

 

What else should I be aware of?

Patients should not donate blood during treatment and for six weeks after stopping. Men should not donate sperm during treatment and for three months after stopping.

 

What are the side effects?

As with most medicines, mycophenolate may cause side-effects although this is not the case for everyone.

 

Possible side-effects include:

  • Headaches and dizziness.
  • Depression and anxiety.
  • Tremor (shaking hands). 
  • Insomnia (not being able to sleep).
  • Nausea, vomiting, cough, abdominal pain.
  • High/low blood pressure.
  • Gastrointestinal side effects such as diarrhoea and constipation.
  • Acne, hair loss, rash and joint pain.

Mycophenolate may also increase the risk of kidney damage or reduce the levels of certain blood cells. You should stop taking mycophenolate and seek medical advice immediately if you experience any of the following:

  • Symptoms such as bleeding, bruising or rash.
  • Change in colour and amount of urine.
  • Long-lasting, unusual changes in behaviour.

 

Need more information?

Please refer to the leaflet included with the medicine for further information,or contact the pharmacy department on: 020 7566 2362.