Immunosuppressive drug, Autoimmune disease, Anemia treatment
- Do not use in patients with known sensitivity to mycophenolate.
- Patients with severe renal dysfunction may require dosage adjustment.
- IV mycophenolate must be given over at least 2 hours – can’t be given by IV bolus or rapid IV infusion.
- For humans there is a black box warning regarding potential increased risk for lymphoma associated with its use.
- It is recommended to avoid use during pregnancy if at all possible as risk to the fetus is possible.
- Veterinary studies of the use of this drug are limited. Adverse event profile is unknown.
- Adverse effects in dogs reported at the time of publishing include vomiting, diarrhea, anorexia, lethargy, lymphopenia, increased rates of dermal infections.
- Because of the immunosuppressive actions increased systemic infection and malignancy rates are also possible.
- In humans, the most common side effects include GI effects and headache. Hypertension and peripheral edema occur in about 30% of patients. Leukopenia occurs in 25 – 45% of patients. Other more rare effects include GI bleeding, severe neutropenia, cough, confusion, tremor, infection and malignant lymphoma.
- Probenecid may potentially increase serum levels of mycophenolic acid and the phenolic glucuronide of mycophenolic acid
- Aluminum or magnesium containing antacids may decrease absorption of mycophenolate – separate by 2 hours.
Oral iron supplement
- May decrease absorption of mycophenolate – separate by 2 hours.
- May be less effective – avoid use.
- Increased serum concentrations of acyclovir and the phenolic glucuronide of mycophenolic acid may occur.
Aspirin / Acetylsalicylic acid
- May potentially increase concentrations of free mycophenolic acid.
- Additive risk for bone marrow suppression – use together is not advised in humans.
- Esomeprazole may reduce mycophenolic acid (MPA; active metabolite) levels.
- Capsules – 250 mg; CellCept® Tablets – 500 mg; CellCept® Powder for oral suspension – 200 mg/mL in 225 mL bottles; CellCept® Lyophilized powder for injection – 500 mg in 20 mL vial; CellCept® Mycophenolate is also available as the sodium salt in oral delayed release tablets – Myfortic®. It does not appear that his dosage form will be useful for veterinary patients.
Veterinary – General