Mycophenolate
A Drug Information Sheet
Why am I being prescribed mycophenolate?
Mycophenolate mofetil (brand name CellCept) 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 reduces the activity of the body's immune system (the body's own defence system), so it is always used with care.
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. Do not crush or chew the capsules. They should be swallowed whole.
Your doctor will advise you about the correct dose.
How long will 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 sickness, diarrhoea, vomiting or abdominal (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. If you develop a sore throat or other infection, a fever, unexplained bruising or bleeding, or if you develop any other unexpected new symptoms after starting mycophenolate, you should tell your doctor or rheumatology nurse specialist straight away. If any of these symptoms are severe, you should stop mycophenolate and see your doctor immediately.
If you have not had chickenpox but come into contact with someone who has chickenpox or shingles, or if you develop chickenpox or shingles, you should stop mycophenolate and see your doctor immediately as you may need special treatment. This is because chickenpox and shingles can be severe in people on treatment such as mycophenolate which has effects on the immune system. Therefore you may require antiviral treatment.
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.
Rarely, people may be allergic to mycophenolate. If this is the case with you, the drug will have to be stopped. Symptoms of allergy include rash, wheezing, shortness of breath, and swelling of the face, lips, tongue or throat.
What other treatments could be used instead of mycophenolate?
A number of other drugs are used in the treatment of rheumatic diseases (see arc leaflet 'Drugs and Arthritis'). Your doctor will discuss these other options with you.
Do 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. Bring this with you when you visit your GP or the hospital. You must not take mycophenolate unless you are having regular checks.
May 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.
Can I have immunisations while 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 and yearly flu vaccines are safe and recommended.
May I drink alcohol while taking mycophenolate?
If you drink alcohol you should only drink it in small amounts because mycophenolate can affect your liver.
Does mycophenolate affect 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 while taking mycophenolate. The drug could pass into the breast milk and the risk to the baby is unknown.
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 the content of this information sheet is correct at time of going to press, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.
