Mycophenolate Mofetil

Indications & Dose:

Prophylaxis of acute rejection in renal transplantation (in combination with a corticosteroid and ciclosporin) (under expert supervision) 

• BY MOUTH

Adult: 1 g twice daily, to be started within 72 hours of transplantation

• BY INTRAVENOUS INFUSION

Adult: 1 g twice daily for maximum 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) (under expert supervision) 

• BY MOUTH

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) (under expert supervision) 

• INITIALLY BY INTRAVENOUS INFUSION

Adult: 1 g twice daily for 4 days, up to a maximum 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 l MYFORTIC (Novartis) Tablet 180mg =250mg MMF120’s 8,500.00 10,000.00 Tablet 360mg =500mgMMF120’s 17,000.00 20,000.00

DOSE:

360mg=0.5g/day MMF Morning and evening

720mg=1g/day MMF Morning and evening

1.08g=1.5g/day MMF Morning and evening

1.44g=2g/day MMF Morning and evening

Renal transplantation

• BY MOUTH

Adult: 720 mg twice daily, to be started within 72 hours of transplantation

Contraindications:

Side Effects:

Common or very common Abdominal pain . acne . agitation . alopecia . anaemia . anorexia . anxiety . arthralgia . blood disorders . confusion . constipation . convulsions . cough . depression . disturbances of blood lipids . disturbances of electrolytes and blood lipids . dizziness . dyspnoea . flatulence . gastro-intestinal bleeding . gastrointestinal inflammation . gastro-intestinal ulceration . gingival hyperplasia . headache . hepatitis . hyperglycaemia . hypertension . hypotension . infections . influenza-like syndrome . insomnia . jaundice . leucopenia . malignancy (particularly of the skin) . myasthenic syndrome . nausea . oedema . pancreatitis . pancytopenia . paraesthesia . rash . red cell aplasia . renal impairment . skin hypertrophy . stomatitis . tachycardia . taste disturbance . thrombocytopenia . tremor . vasodilatation . vomiting . weight loss

Frequency not known Interstitial lung disease . intestinal villous atrophy . progressive multifocal leucoencephalopathy . pulmonary fibrosis

PREGNANCY Avoid unless no suitable alternative— congenital malformations and spontaneous abortions reported.

BREAST FEEDING Manufacturer advises avoid— present in milk in animal studies.

RENAL IMPAIRMENT No data available in cardiac or hepatic transplant patients with renal impairment

Cautions:

Active serious gastro-intestinal disease (risk of haemorrhage, ulceration and perforation) . delayed graft function . elderly (increased risk of infection, gastrointestinal haemorrhage and pulmonary oedema) . increased susceptibility to skin cancer (avoid exposure to strong sunlight) . risk of hypogammaglobulinaemia or bronchiectasis when used in combination with other immunosuppressants

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