mycophenolate (Intravenous route)

Pronunciation

mye-koe-FEN-oh-late MOE-fe-til hye-droe-KLOR-ide

Intravenous route(Powder for Solution)

Provide information on pregnancy prevention and planning to female patients of childbearing potential, as this drug is associated with increased risk of first-trimester pregnancy loss and congenital malformations. In addition, use may increase susceptibility to infection. Lymphoma may develop as a result of immunosuppression. Only physicians experienced in immunosuppressive therapy and management of organ transplant recipients should prescribe this drug, and they should have complete information needed for patient followup .

Commonly used brand name(s)

In the U.S.

  • Cellcept

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Immune Suppressant

Uses For mycophenolate

Mycophenolate injection belongs to a group of medicines known as immunosuppressive agents. It is used with other medicines to lower the body's natural immunity in patients who receive organ transplants (eg, kidney, heart, or liver).

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When a patient receives an organ transplant, the body's white blood cells will try to get rid of (reject) the transplanted organ. Mycophenolate injection prevents the white blood cells from rejecting the transplanted organ.

mycophenolate is to be given only by or under the direct supervision of your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, mycophenolate is used in certain patients with the following medical condition:

  • Lupus nephritis.

Before Using mycophenolate

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For mycophenolate, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to mycophenolate or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of mycophenolate injection in children receiving kidney transplants.

Appropriate studies have not been performed on the relationship of age to the effects of mycophenolate injection in children receiving heart or liver transplants. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of mycophenolate injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving mycophenolate injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters D Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving mycophenolate, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using mycophenolate with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Activated Charcoal
  • Cholestyramine
  • Colesevelam
  • Colestipol
  • Dexlansoprazole
  • Esomeprazole
  • Lansoprazole
  • Metronidazole
  • Norfloxacin
  • Omeprazole
  • Pantoprazole
  • Rabeprazole
  • Rifampin

Using mycophenolate with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ciprofloxacin
  • Cyclosporine
  • Desogestrel
  • Dienogest
  • Drospirenone
  • Estradiol Cypionate
  • Estradiol Valerate
  • Ethinyl Estradiol
  • Ethynodiol Diacetate
  • Etonogestrel
  • Levonorgestrel
  • Medroxyprogesterone Acetate
  • Mestranol
  • Norelgestromin
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Sevelamer
  • Valacyclovir

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of mycophenolate. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bone marrow problems (eg, neutropenia) or
  • Hepatitis B or C infection or
  • Stomach ulcers or bleeding—Use with caution. May make these conditions worse.
  • Infection—May decrease your ability to fight an infection.
  • Kelley-Seegmiller syndrome (rare genetic disease) or
  • Lesch-Nyhan syndrome (rare genetic disease)—Should not be used in patients with these conditions.
  • Kidney disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of mycophenolate

A nurse or other trained health professional will give you mycophenolate in a hospital. mycophenolate is given through a needle placed in one of your veins.

Your doctor will give you a few doses of mycophenolate until your condition improves, and then switch you to an oral medicine that works the same way. If you have any questions about this, talk to your doctor.

Precautions While Using mycophenolate

It is very important that your doctor check your progress while you are receiving mycophenolate. Your doctor will do blood tests to make sure that mycophenolate injection is working properly and to check for unwanted effects.

Using mycophenolate while you are pregnant can harm your unborn baby or cause a miscarriage during the first 3 months. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using mycophenolate to make sure you are not pregnant. Your birth control pills may not work as well while you are using mycophenolate. You must use two forms of birth control together for 1 month before starting mycophenolate, for the entire time that you are being treated, and for 6 weeks after you receive your last dose of mycophenolate. Use birth control pills together with another form of birth control, such as a condom, diaphragm, or contraceptive foam or jelly. If you think you have become pregnant while using the medicine, tell your doctor right away.

Mycophenolate injection can temporarily lower the number of white blood cells in your blood, which increases the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you have a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Mycophenolate may cause pure red cell aplasia (PRCA). This is a very rare condition where the body no longer makes red blood cells and the patient has severe anemia. Check with your doctor right away if you have a fever and sore throat, pale skin, unusual bleeding or bruising, or unusual tiredness or weakness.

mycophenolate may increase your risk of developing a serious and rare brain infection called progressive multifocal leukoencephalopathy (PML). Check with your doctor right away if you are having more than one of these symptoms: vision changes, loss of coordination, clumsiness, memory loss, difficulty speaking or understanding what others say, and weakness in the legs.

mycophenolate may increase your risk of developing rare and serious virus infections, such as shingles, herpes, cytomegalovirus (CMV) infection, polyomavirus associated nephropathy (PVAN), and BK virus-associated nephropathy (BKVAN). The BK virus may affect how your kidneys work and cause a transplanted kidney to fail. Check with your doctor right away if you are having more than one of these symptoms: bloody urine, a decreased frequency or amount of urine, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble with breathing, unusual tiredness or weakness, vomiting, or weight gain.

mycophenolate may cause reactivation of hepatitis B or C infection. Check with your doctor right away if you have the following symptoms while using mycophenolate: dark-colored urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes.

While you are receiving mycophenolate injection, and after you stop, do not have any immunizations (vaccines) without your doctor's approval. Mycophenolate injection will lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent.

Using mycophenolate may increase your risk of getting skin cancer or cancer of the lymph system (lymphoma). Talk to your doctor if you have concerns about this risk.

Use sunscreen or sunblock lotions with a sun protection factor (SPF) of at least 15 on a regular basis when you are outdoors. Wear protective clothing and hats and stay out of direct sunlight, especially between the hours of 10 a.m. and 3 p.m. Avoid sunlamps and tanning beds.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

mycophenolate Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Blood in the urine
  • chest pain or discomfort
  • cough or hoarseness
  • fever or chills
  • increased cough
  • lower back or side pain
  • painful or difficult urination
  • shortness of breath
  • swelling of the feet or lower legs
Less common
  • Abdominal or stomach pain
  • black, tarry stools
  • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, or warmth at injection site
  • bloody vomit
  • enlarged gums
  • irregular heartbeat
  • joint pain
  • muscle aches or pain
  • pinpoint red spots on the skin
  • red, inflamed, or bleeding gums
  • sores inside the mouth
  • trembling or shaking of the hands or feet
  • unusual bleeding or bruising
  • white patches on the mouth, tongue, or throat
Incidence not known
  • Abdominal or stomach distention
  • back pain
  • blue lips, fingernails, or skin
  • blurred vision
  • chronic or occasional diarrhea
  • clumsiness
  • confusion
  • convulsions
  • coughing or spitting up blood
  • difficult or troubled breathing
  • difficulty speaking or understanding what others say
  • dizziness
  • drowsiness
  • general feeling of illness or nausea
  • headache
  • heart murmur
  • irregular, fast or slow, or shallow breathing
  • loss of coordination
  • memory loss
  • night sweats
  • severe headache
  • sore throat
  • stiff neck or back
  • stools that float, are foul smelling, or "fatty"
  • sudden high fever or low-grade fever for months
  • unusual tiredness or weakness
  • vision changes
  • weakness in the legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Constipation
  • diarrhea
  • heartburn
  • nausea
  • stomach pain
  • vomiting
  • weakness
Less common
  • Acne
  • skin rash
  • trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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