Mycophenolate (patient information)

IMPORTANT WARNING:
Mycophenolate may decrease your ability to fight infection. Wash your hands often and avoid people who are sick while you are taking this medication. If you experience any of the following symptoms, call your doctor immediately: sore throat; fever; chills; colds sores; blisters; swollen glands; extreme tiredness; loss of appetite; tingling or burning in one part of the body; general weak or sick feeling; and other signs of infection.

Mycophenolate may increase your risk of developing certain types of cancer, including lymphoma (a type of cancer that develops in the lymph system) and skin cancer. Plan to avoid unnecessary or prolonged exposure to real and artificial sunlight and light therapy and to wear protective clothing, sunglasses, and sunscreen. This will decrease your risk of developing skin cancer. Call your doctor if you experience any of the following symptoms: pain or swelling in the neck, groin, or armpits; a change in the appearance of a mole; skin changes; or sores that do not heal. Talk to your doctor about the risks of taking mycophenolate.

Why is this medication prescribed
Mycophenolate is used with other medications to prevent the body from rejecting kidney, heart, and liver transplants. Mycophenolate is in a class of medications called immunosuppressive agents. It works by weakening the body's immune system so it will not attack and reject the transplanted organ.

How should this medicine be used
Mycophenolate comes as a capsule, a tablet, and a suspension (liquid) to take by mouth. It is usually taken twice a day on an empty stomach. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mycophenolate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the tablets and capsules whole; do not split, chew, or crush them. Do not open the capsules.

Do not mix mycophenolate liquid with any other medication.

Be careful not to spill the liquid or to splash it onto your skin. If you do get the liquid on your skin, wash the area well with soap and water. If you get the liquid in your eyes, wash with plain water. Use wet paper towels to wipe up any spills.

Mycophenolate prevents transplant rejection only as long as you are taking the medication. Continue to take mycophenolate even if you feel well. Do not stop taking mycophenolate without talking to your doctor.

Other uses for this medicine
Mycophenolate is also sometimes used to treat refractory uveitis (inflammation of the eyes that has not responded to other treatment), Churg-Strauss syndrome (a disease in which the body makes too many immune cells and they damage organs), and certain types of lupus nephritis (a disease in which the body attacks its own kidneys). Talk to your doctor about the possible risks of using this drug for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow
Before taking mycophenolate


 * tell your doctor and pharmacist if you are allergic to mycophenolate, mycophenolic acid, or any other medications.
 * tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetazolamide (Diamox); acyclovir (Zovirax); antibiotics; azathioprine (Imuran); chlorothiazide (Diuril); cimetidine (Tagamet); cholestyramine (Questran); colestipol (Colestid); ethacrynic acid (Edecrin); furosemide (Lasix); ganciclovir (Cytovene); isoproterenol (Isuprel); meperidine (Demerol); morphine (MS Contin, MSIR, Oramorph); oral contraceptives (birth control pills); phenytoin (Dilantin); probenecid (Benemid); procainamide (Pronestyl); quinine; salicylate pain relievers such as aspirin, choline magnesium trisalicylate (Trisalate), choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others) and salsalate (Argesic, Disalcid, Salgesic); and theophylline (TheoDur). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
 * if you are taking antacids, take them 2 hours before or 4 hours after mycophenolate.
 * tell your doctor if you have or have ever had Lesch-Nyhan or Keeley-Seegmiller syndrome (inherited diseases that cause high levels of a certain substance in the blood, joint pain, and problems with motion and behavior);any disease that affects your stomach, intestines, or digestive system; any type of cancer; phenylketonuria (an inherited diseases that requires patients to follow a special diet to prevent mental retardation); and liver or kidney disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. You must use two forms of birth control before beginning treatment with mycophenolate, during treatment, and for 6 weeks after treatment. Your doctor will not allow you to begin taking mycophenolate unless you have had a negative pregnancy test. If you become pregnant while you are taking mycophenolate, call your doctor immediately. Do not breastfeed while you are taking this medication.
 * do not have any vaccinations (shots) without talking to your doctor.
 * if you have phenylketonuria (PKU, a inherited condition in which a special diet must be followed to prevent mental retardation), you should know that mycophenolate liquid may be sweetened with aspartame that forms phenylalanine.

What special dietary instructions should I follow
Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Minor side effects
''Mycophenolate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:''


 * diarrhea
 * constipation
 * stomach pain
 * upset stomach
 * vomiting
 * difficulty falling asleep or staying asleep
 * pain, especially in the back, muscles, or joints

Severe side effects
''Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those listed in the IMPORTANT WARNING section, call your doctor immediately:''


 * swelling of the hands, feet, ankles, or lower legs
 * difficulty breathing
 * shaking hands that you cannot control
 * unusual bruising or bleeding
 * headache
 * fast heartbeat
 * excessive tiredness
 * dizziness
 * pale skin
 * weakness
 * black and tarry stools
 * red blood in stools
 * bloody vomit
 * vomiting material that looks like coffee grounds
 * loose, floppy muscles
 * white patches in mouth or throat
 * swelling of gums
 * vision changes
 * rash

''Mycophenolate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.''

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Mycophenolate liquid may also be stored in a refrigerator, but should not be frozen. Throw away any unused mycophenolate liquid after 60 days and throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:


 * upset stomach
 * vomiting
 * diarrhea
 * fever, chills, and other signs of infection

What other information should I know
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to mycophenolate.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

 * CellCept®