CELLCEPT
MYCOPHENOLATE MOFETIL · by MARTIN DOW
Composition
Tab 250/500 mg: Mycopheholate mofetil 250/500 mg.
Indications & Dosage
Prophylaxis of acute rejection in renal transplantation (in combination with a corticosteroid and ciclosporin): Adult: 1 g twice daily, to be started within 72 hours of transplantation. BY IV INF: Adult: 1 g twice daily for max. 14 days, then transfer to oral therapy, to be started within 24 hours of transplantation. Prophylaxis of acute rejection in cardiac transplantation (in combination with ciclosporin and corticosteroids): Adult: 1.5 g twice daily, to be started within 5 days of transplantation. Prophylaxis of acute rejection in hepatic transplantation (in combination with ciclosporin and corticosteroids): BY IV INF: Adult: 1 g twice daily for 4 days, up to a max. of 14 days, to be started within 24 hours of transplantation, then (by mouth) 1.5 g twice daily, the dose route should be changed as soon as is tolerated. Renal transplantation: Adult: 1 gm twice daily, to be started within 72 hours of transplantation.
Contraindications
Pregnancy, lactation.
Precautions
Monitor full blood count every week for 4 weeks then twice a month for 2 months then every month in the first year (consider interrupting treatment if neutropenia develops). Active serious GI disease (risk of haemorrhage, ulceration and perforation), delayed graft, function, elderly, increased susceptibility to skin cancer (avoid exposure to strong sunlight), risk of hypogamma globulinaemia or bronchiectasis when used in combination with other immunosuppressants. Measure serum immunoglobulin levels if recurrent infections develop, and consider bronchiectasis or pulmonary fibrosis if persistent respiratory symptoms such as cough and dyspnea develop.
Interactions
Acyclovir, valaciclovir, ganciclovir, antacids, azathioprine, cholestyramine, probenecid, vaccines, tacrolimus
Side Effects
Abdominal pain, acne, agitation, alopecia, anaemia, anorexia, anxiety, arthralgia, blood disorders, confusion, constipation, convulsions, cough, depression, disturbances of electrolytes and blood lipids, dizziness, dyspnea, GI upset, GI bleeding, GI inflammation, GI ulceration, gingival hyperplasia, hepatitis, hyperglycaemia, hypertension, hypotension, infections, influenza-like syndrome, insomnia, jaundice, leucopenia, malignancy, myasthenic syndrome, oedema, pancreatitis, pancytopenia, paraesthesia, rash, red cell aplasia, renal impairment, skin hypertrophy, stomatitis, tachycardia, thrombocytopenia, tremor, vasodilatation, weight loss, interstitial lung disease, intestinal villous atrophy, progressive multifocal leucoencephalopathy, pulmonary fibrosis