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At a glance

Mycophenolate Mofetil is an immunosuppressant used to prevent organ rejection after transplantation. It suppresses the immune system by inhibiting lymphocyte proliferation.

Indications
  • Prophylaxis of acute organ rejection in renal transplant
  • Prophylaxis of acute organ rejection in cardiac transplant
  • Prophylaxis of acute organ rejection in hepatic transplant
  • Induction and maintenance therapy of Class III-V lupus nephritis
Pharmacology

Mycophenolate mofetil is the 2-morpholinoethyl ester of mycophenolic acid (MPA). MPA is a potent, selective, uncompetitive and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH), and therefore inhibits the de novo pathway of guanosine nucleotide synthesis. MPA has more potent cytostatic effects on lymphocytes than on other cells because T- and B lymphocytes are critically dependent for their proliferation on de novo synthesis of purines.

Dosage

Renal Transplant (Adult): 1 g twice daily (2 g daily dose)

Renal Transplant (Pediatric, 3 months-18 years): BSA 1.25-1.5 m²: 750 mg twice daily; BSA >1.5 m²: 1 g twice daily

Cardiac Transplant (Adult): 1.5 g twice daily (3 g daily dose)

Hepatic Transplant (Adult): 1.5 g twice daily (3 g daily dose)

Lupus Nephritis (Adult): Induction: 750 mg-1.5 g twice daily; Maintenance: 500 mg-1 g twice daily

Lupus Nephritis (Pediatric): Induction: 600 mg/m² twice daily (max 2 g/day); Maintenance: 300 mg/m² twice daily

Side effects

Common Side Effects (>10%):

  • Diarrhea (21%)
  • Leukopenia (34%)
  • Nausea (23%)
  • Vomiting
  • Abdominal pain (27%)
  • Sepsis
  • Gastrointestinal candidiasis
  • Urinary tract infection (34%)
  • Hyperglycemia (44%)
  • Hypertension (28%)

Serious: Opportunistic infections, lymphoma, skin cancers, GI bleeding

Use in pregnancy

Use in Pregnancy: Mycophenolate Mofetil is highly unsafe during pregnancy (Category D); definite evidence of severe fetal harm. Can cause birth defects and abortion. Completely contraindicated.

Pregnancy Category: D — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • May increase new or reactive viral infections (hepatitis B/C, polyomaviruses)
  • May cause blood dyscrasias (including pure red cell aplasia)
  • May cause serious GI tract complications (bleeding, perforations, ulcers)
  • May increase risk of lymphomas and other malignancies
  • Avoid live vaccines
  • Do not donate blood during therapy
  • Use sunscreen to prevent skin cancer
Overdose effects

Overdose may cause over suppression of immune system and increased risk of infections; if neutropenia develops, interrupt or reduce dose.

Storage conditions

Store below 30°C in a cool and dry place, away from light; keep out of reach of children.

Mycophenolate Mofetil — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.