Mycophenolate
Mycophenolate (full name mycophenolate mofetil and brand name
CellCept) is a type of drug known as a disease-modifying
anti-rheumatic drug, or DMARD. These drugs have the effect of
dampening down the underlying disease process, rather than simply
treating symptoms. Mycophenolate reduces the activity of the body’s
immune system (the body’s own defence system), so it is always used
with care.
Why is mycophenolate prescribed?
Mycophenolate is used in the treatment of several different
types of rheumatic disease, including systemic lupus erythematosus
(SLE) and diseases in which there is inflammation of blood vessels
('vasculitis').
Mycophenolate may also be used after organ transplantation, for
example in kidney transplants.
When and how do I take mycophenolate?
Mycophenolate is usually taken in capsule form twice a day. The
capsules should be taken with a glass of water or with food. They
should be swallowed whole and not crushed or chewed.
Your doctor will advise you about the correct dose.
How long does mycophenolate take to work?
Mycophenolate does not work immediately. It may be up to 3
months before you notice any benefit.
What are the possible risks or side-effects?
The most common side-effects of mycophenolate are nausea
(feeling sick), diarrhoea, vomiting or stomach pain. Mycophenolate
can also affect your blood count (one of the effects is that fewer
blood cells are made) and can make you more likely to develop
infections. You should tell your doctor or rheumatology nurse
specialist straight away if you develop any of the following after
starting mycophenolate:
- a sore throat
- a fever
- any other symptoms of infection
- unexplained bruising or bleeding
- any other new symptoms or anything else that concerns you.
You should stop mycophenolate and see your doctor immediately
if:
- any of the symptoms listed above are severe
- you have not had chickenpox and you come into contact with
someone who has chickenpox or shingles
- you develop chickenpox or shingles.
Chickenpox and shingles can be severe in people on treatments
such as mycophenolate which affect the immune system. Therefore you
may need antiviral treatment, which your doctor will be able to
prescribe.
There is a slightly increased risk of certain types of cancer
with mycophenolate. Discuss this with your doctor. Because of the
small increase in risk of skin cancer, you should avoid exposure to
strong sunlight and protect your skin with sunblock or
sunscreen.
What other treatments could be used instead of
mycophenolate?
A number of other drugs are used in
the treatment of rheumatic diseases. Your doctor will discuss these
other options with you.
Will I need any special checks while on mycophenolate?
Because mycophenolate can affect the
blood count, and can sometimes cause liver or kidney problems, your
doctor will arrange for you to have a blood test before you start
treatment and then regular blood checks while on mycophenolate.
This is very important. You may be asked to keep a record booklet
with your blood test results, and you should bring this with you
when you visit your GP or the hospital. You must not take
mycophenolate unless you are having regular checks.
Can I take other medicines along with mycophenolate?
Mycophenolate may be prescribed along with other drugs in
treating your condition. Some drugs interact with mycophenolate, so
you should discuss any new medications with your doctor before
starting them, and you should always tell any other doctor treating
you that you are taking mycophenolate.
Mycophenolate is not a painkiller. If you are already on a
non-steroidal anti-inflammatory drug (NSAID) or painkillers you may
carry on taking these as well as mycophenolate, unless your doctor
advises otherwise.
Do not take over-the-counter preparations or herbal remedies
without discussing this first with your doctor, rheumatology nurse
or pharmacist.
What about immunisations?
If you are on mycophenolate it is recommended that you should
not be immunised with 'live' vaccines such as yellow fever.
However, in certain situations a live vaccine may be necessary (for
example rubella immunisation in women of childbearing age), in
which case your doctor will discuss the possible risks and benefits
of the immunisation with you.
Pneumovax (which gives protection
against the commonest cause of pneumonia) and yearly flu vaccines
are safe and recommended.
Can I drink alcohol while on mycophenolate?
If you drink alcohol you should only drink it in small amounts
because mycophenolate can affect your liver.
Does mycophenolate affect fertility or pregnancy?
You should not take mycophenolate when pregnant, and you should
not become pregnant for at least 6 weeks after stopping
mycophenolate. If you are planning a family or if you become
pregnant while taking mycophenolate, you should discuss this with
your doctor as soon as possible.
What about breastfeeding?
You should not breastfeed if you are
on mycophenolate. The drug may pass into the breast milk and could
be harmful to your baby.
Where can I obtain further information?
If you would like any further information about mycophenolate,
or if you have any concerns about your treatment, you should
discuss this with your doctor, rheumatology nurse or
pharmacist.
Remember to keep all medicines out of reach of
children.
PLEASE NOTE: We have made
every effort to ensure that this content is correct at time of
publication, but remember that information about drugs may change.
This page is for general education only and does not
list all the uses and side-effects associated with this
drug. For full details please see the drug information
leaflet that comes with your medicine. Your doctor will assess your
medical circumstances and draw your attention to any information or
side-effects that may be relevant in your particular case.
Our drug information is revised
annually and published at the start of the year.