Mycophenolate Mofetil
1 medicine
Mycophenolate mofetil is an immunosuppressant used after organ transplant and in autoimmune disease, but it is a severe teratogen: pregnancy must be excluded and prevented with two reliable contraception methods before and during treatment.
Key facts
- Mycophenolate mofetil is an immunosuppressant used to prevent rejection after kidney, heart or liver transplant, and to treat autoimmune conditions such as lupus nephritis.
- It causes miscarriage and serious birth defects if taken during pregnancy. Anyone who could become pregnant must have a negative pregnancy test before starting, use two effective methods of contraception during treatment and for six weeks after stopping, and avoid breastfeeding.
- It suppresses the immune system, so regular blood tests to check white blood cell counts are needed, and infection risk is increased.
- Seek urgent care for fever, sore throat, unusual bruising or bleeding, or any sign of infection.
What mycophenolate mofetil treats
Mycophenolate mofetil prevents the immune system from rejecting a transplanted kidney, heart or liver, usually alongside other immunosuppressants such as ciclosporin or tacrolimus and a corticosteroid. It also treats lupus nephritis, kidney inflammation caused by systemic lupus erythematosus, and is used for other autoimmune conditions where the immune system attacks the body's own tissue.
How mycophenolate mofetil works
Mycophenolate mofetil is converted in the body to mycophenolic acid, which blocks an enzyme called inosine monophosphate dehydrogenase. Lymphocytes, the white blood cells most responsible for organ rejection and autoimmune attack, depend heavily on this enzyme to build new DNA. Blocking it stops lymphocytes multiplying, weakening the immune response without affecting most other cell types as strongly.
Before you take it
- Do not take mycophenolate mofetil if you are pregnant, planning pregnancy, or breastfeeding; it causes first-trimester pregnancy loss and major malformations, including of the ears, face, heart and limbs.
- Anyone who could become pregnant needs a pregnancy test before starting, two forms of effective contraception used together throughout treatment and for six weeks afterward, and prompt medical advice if pregnancy is suspected.
- Tell your prescriber about all other medicines; antacids, iron supplements and cholestyramine can reduce absorption, and live vaccines should be avoided during treatment.
- Regular full blood count monitoring is required, more frequently at the start of treatment, to catch low white cell or platelet counts early.
Side effects
Common effects include diarrhoea, nausea, vomiting, stomach pain and low blood cell counts.
Stop and seek urgent medical care for any of these:
- Fever, sore throat, mouth ulcers or other signs of infection.
- Unusual bruising, bleeding gums or blood in urine or stool.
- Severe or persistent diarrhoea or vomiting.
- Any suspicion of pregnancy.
Safety essentials
- Pregnancy prevention is the defining safety requirement of mycophenolate mofetil: a confirmed negative pregnancy test before starting, two effective contraception methods used together during treatment and for six weeks after stopping, and no breastfeeding.
- Because it suppresses the immune system and bone marrow, you need scheduled blood count monitoring for the duration of treatment and should report infection symptoms without delay.
- Do not share this medicine, and dispose of unused capsules or tablets as your pharmacist advises rather than in household waste, since it is handled as a cytotoxic drug.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.