Mycophenolate

Medication Information Leaflet

What is this medication for?

Mycophenolate belongs to a group of medications known as immunosuppressive agents. It is used to prevent your body from rejecting a transplanted organ. 

This medication can also be used to treat autoimmune diseases, where the body’s natural defence system attacks its own body cells. 

How should I take/use this medication?

Mycophenolate mofetil: Take this medication half to one hour before food.
Mycophenolate sodium EC tablet: May be taken with or without food.

Do not chew, crush, or open the capsules/tablets. The tablets/capsules should be swallowed as a whole.

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Then take your next dose at the usual time. 

Do not take two doses to make up for the missed dose. 

What precautions should I take?

  • Inform your healthcare professional if you: 
  • Are allergic to mycophenolate sodium, mycophenolate mofetil, or to any of the ingredients.
  • Have cancer, kidney disease, liver disease, stomach/intestinal problems (e.g., gastric ulcers), diabetes, high blood pressure, high cholesterol, or symptoms of infection.
  • Are going for immunizations (vaccinations) as mycophenolate may either increase the chance of an infection or make the vaccine less effective.
  • Are pregnant, planning to have a child, or breastfeeding.
    • Mycophenolate has been reported to be able to cause harm to the foetus when taken during pregnancy (miscarriages and birth defects).
    • Mycophenolate may decrease the effectiveness of birth control pills. Therefore, it is important to use an additional form of birth control (barrier methods e.g., condoms) to prevent pregnancy.  Inform your doctor immediately if you think you are pregnant or if you have missed your menstrual period.
    • Women of childbearing age should have a negative pregnancy test before starting this medication. Also, it is important to use two reliable forms of birth control (unless the contraceptive method is intrauterine device, tubal sterilisation, or vasectomy) before beginning treatment and continue for at least 6 weeks after mycophenolate is stopped. 
    • Sexually active male patients and their female partners should use birth control during treatment of the male patient and for at least 90 days after the last dose. 
    • Breast-feeding is not recommended during and for at least 6 weeks after stopping mycophenolate treatment as mycophenolate may enter into the breastmilk.
  • Do not donate blood during treatment with mycophenolate and for at least 6 weeks after stopping treatment.
  • Avoid prolonged sun exposure. Use sunscreen and wear protective clothing when you are outdoor.

What are some common side-effects of this medication?

Certain side effects of this medicine are not unusual and may even disappear during treatment. If any of the following effects persist or are severe, consult your doctor.
  • Diarrhoea, constipation, nausea, vomiting,or stomach pain
    • These symptoms may improve as you get used to the medication.
    • Taking it after food may reduce nausea/vomit
  • Dizziness, drowsiness
    • Avoid driving or using machinery.
    • Avoid taking alcohol.
  • Headache, difficulty sleeping (insomnia)
    • These symptoms may improve as you get used to the medication.
  • Increase in blood pressure
    • Regularly monitor your blood pressure.
  • Swelling and growth of the gums 
    • Brush and floss your teeth daily and see your dentist regularly.
  • Muscle pain, back/ joint pain,or leg cramps

What are some rare but serious side-effects that I need to seek medical advice immediately?

Inform your doctor immediately if any of these rare but serious side effects occur: 
  • Allergic reaction with symptoms such as: 
    • Swollen face/eyes/lips/tongue
    • Difficulty in breathing
    • Itchy skin rashes over your whole body
  • Change in color or size of moles or develop new skin lumps.
  • Chest pain, abnormal heartbeat, or swelling of the legs/ankle/feet. 
  • Persistent abdominal pain, light-colored stool, dark urine, yellow skin or eyes.
  • Black/tarry stools, vomit that looks like coffee grounds.
  • Easy bleeding/bruising, or  pale-looking.
  • Fever (temperature higher than 38°C), chills, cough, feel generally unwell, pain when passing urine, or blood in urine.
  • Mental/mood changes, vision changes, difficulty speaking or thinking, or change in balance.
Your doctor will perform regular blood monitoring (full blood count and liver function test) to watch out for complications. Keep to your appointments regularly.

For patients who are on long-term mycophenolate, there is also an increased chance of skin cancer and lymphoma.  

What food or medication should I avoid when I take this medication?

  • Inform your doctor if:
    • You are taking any other medications, supplements, traditional medications and herbal remedies. 
      • Medications that may interact with mycophenolate include cholestyramine, antivirals, antibiotics, immunosuppressive medications, and hormonal contraceptives.
      • Take indigestion remedies (antacids) or magnesium supplements at least 2 hours after taking mycophenolate.
  • Avoid drinking alcohol as it can increase the risk of drowsiness or dizziness caused by this medication.
  • Avoid consumption of raw or undercooked food (e.g., half-boiled eggs) while on this medication as it may reduce the ability of your body to fight against infection.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin. 


Disclaimers
If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Oct 2022
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