Mycophenolate Mofetil

Why am I being prescribed Mycophenolate?

Mycophenolate is considered for rheumatology patients whose symptoms are not well controlled. This happens when the immune system is overactive, and mycophenolate helps to ‘dampen it down’. It needs to be monitored carefully to make sure that it does not interfere with liver function and that the activity of the immune system is not suppressed too much.

When do I take mycophenolate?

It should be taken twice a day with food. The dose varies from person to person and you will be told this before you start. Usually you will start on a low dose and gradually increase. A common regimen used in the Rheumatology department is:

500mg once daily after breakfast for 1 week

500mg twice daily, after breakfast and evening meal for 1 week

Then you need a blood test

If blood tests satisfactory (i.e. results must be known)

1g (i.e. 1000mg) in the morning and 500mg in the evening for 2 weeks

Then you need another blood test

If blood tests satisfactory (i.e. results must be known)

1g (i.e. 1000mg) twice daily; stay on this dose

Do I need to continue blood tests after the first few weeks on mycophenolate?

It is very important that you have regular blood tests whilst you are taking it. These should be done once a fortnight to start with and your rheumatology doctor or practitioner will tell you when they may be reduced. The blood tests will also show if the drug is reducing your blood cells too much and also whether it is affecting anything else in the body such as the liver, or the balance of chemicals in your blood.

You will be given a booklet, in which you can keep the results of your monitoring blood tests.

What are the possible side effects?

Sometimes, mycophenolate may cause vomiting, diarrhoea, stomach pain, headache or breathlessness and you may be more likely to get infections. If you suffer from any unusual symptoms, or if you develop infection, fever, unexplained bruising or bleeding telephone your own doctor or telephone the rheumatology help-line (01223 217398).

If you have not had chicken pox or shingles and come into contact with someone who is ill with either, or if you develop either disease yourself, contact your doctor immediately.

There may be a very small increased risk of certain types of cancer with mycophenolate. Use a sun block in summer, to reduce the possibility of skin cancer

How long will mycophenolate take to work?

It will not work immediately and it may be several weeks before you notice a difference.

Shall I continue with all my other medication?

Continue all the medication you take for other conditions and do not stop your painkillers. Your doctor or practitioner will advise you about whether to continue anti-inflammatory drugs. If you are taking steroids (prednisolone), continue on the dose advised by your doctor or practitioner. You may be able to reduce this later when the mycophenolate is working.

Are there any special precautions to take whilst taking mycophenolate?

As it may affect the liver, it is important not to drink too much alcohol. You may have small amounts but you must not drink too much at once. Your doctor or practitioner will advise you. You should not get pregnant/father a child whilst either partner is taking mycophenolate. Use effective contraception and discuss switching to alternative medicines with your doctor or practitioner, if you want to have (more) children.

Can I take other medicines with mycophenolate?

Some drugs interact with mycophenolate and you should always tell any doctor, dentist or pharmacist treating you that you are taking it.

Can I have vaccinations whilst on mycophenolate?

It is recommended that you should not receive any ‘live’ vaccines such as polio, rubella (German measles) and yellow fever. The ‘flu’ and pneumovax vaccines are not live and may be received safely. If you are in contact with babies or children who have received vaccinations, telephone the rheumatology help-line for advice.

Can mycophenolate be taken in pregnancy?

It is very important that you do not take mycophenolate during pregnancy or whilst you are breastfeeding. You need to plan ahead and stop it in advance. Discuss this with your doctor.

Where can I obtain further information?

From your rheumatology doctor, your own G.P, or from the rheumatology practitioners via the rheumatology help-line on 01223 217398.

Remember to keep all medicines out of reach of children

Please note that this information sheet does not list all the possible side effects of mycophenolate and it is important that you read the drug information sheet in the packaging of the tablets. Sometimes this can be alarming so if you are worried about anything, speak to your doctor or practitioner.

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