Mycophenolate Mofetil, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth or given by IV to prevent rejection of heart, kidney or liver transplants. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• You may get infections more easily when you are taking this medicine, including a serious brain infection.
• You may develop certain types of cancer during treatment with this medicine. This medicine may cause other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: immunosuppressant

Generic and brand names: mycophenolate mofetil, oral; mycophenolate mofetil hydrochloride, injection; CellCept; CellCept Oral Suspension; CellCept Intravenous

What is this medicine used for?

This medicine is taken by mouth or given by IV to prevent rejection of heart, kidney or liver transplants. It is used along with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Kidney disease
• Lack of HGPRT enzyme (Lesch-Nyhan or Kelley-Seegmiller syndrome)
• Phenylketonuria (PKU). The liquid form contains phenylalanine.
• Ulcers or other stomach problems

Also, tell your healthcare provider if you have a fever, cough, sore throat, or any other signs of an injection.

Females of childbearing age: Tell your healthcare provider if you are pregnant or breast-feeding. Do not take this medicine during pregnancy because it will harm the baby. If you become pregnant while taking this medicine, contact your healthcare provider right away. You may need a pregnancy test before starting treatment, 8 to 10 days later, and regularly during treatment with this medicine. Your healthcare provider will recommend that you use 2 reliable methods of birth control while you are taking this medicine and for 6 weeks after stopping therapy to be sure you will not become pregnant. Hormonal birth control methods may not work as well while you are taking this medicine, and you could get pregnant. Do not breast-feed while taking this medicine.

How do I use it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less or take it longer than prescribed. Take this medicine on an empty stomach (1 hour before or 2 hours after meals), unless your healthcare provider tells you otherwise.

This medicine is available in tablet, capsule, and liquid forms. Swallow capsules and tablets whole. Do not open, chew, or crush them. If a capsule is broken and some of the medicine gets on your skin, wash the skin thoroughly.

If you have the liquid form, shake it well before using and measure your dose carefully. Use the measuring spoon, cup, dropper, or oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct. Do not mix the oral liquid with any other liquid or medicine.

Take this medicine for as long as directed by your healthcare provider. Do not stop taking it when you feel better. Do not miss doses.

Check with your healthcare provider before using this medicine in children.

The injection form of this medicine is given as a slow infusion into a vein by your healthcare provider.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, diarrhea.

What should I watch out for?

You will need to have blood tests regularly to find out how this medicine is affecting you. Keep all your appointments for blood tests.

This medicine may lower the number of certain types of blood cells in your body. You may get infections or bleed more easily when you are taking this medicine. Stay away from people with colds, flu, or other infections. Also, do not have any vaccines without getting your healthcare provider's approval first. Contact your healthcare provider right away if you have any signs of infection, unusual bruising or bleeding, unusual tiredness or weakness, or severe dizziness or fainting.

This medicine may cause an infection of the brain that may cause death. Contact your provider right away if you: are weak on one side of the body, are confused or having trouble thinking, or if you cannot control your muscles.

There is a risk that you may develop certain types of cancer during treatment with this medicine. You may be at an increased risk for skin cancer. Wear sunscreen and protective clothing when outside. Ask your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; rapid heartbeat; chest pain; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Unexplained fever, chills, sore throat, or cough; loss of balance; trouble walking; confusion; paralysis; severe abdominal pain or diarrhea; bloody vomit or vomit that looks like coffee grounds; blood in the bowel movement; unusual bruising or bleeding; unusual tiredness or weakness; severe dizziness or fainting; shaking or trembling in your hands; swelling of hands or feet; chest pain; decreased or painful urination; white patches or sores in your mouth; earache; continued or severe headache; unusual changes in skin moles or new skin moles; stuffy or runny nose.

Other: Mild nausea, or vomiting; mild headache; constipation, rash, loss of appetite, trouble sleeping.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antacids that contain aluminum, calcium, or magnesium, such as Gaviscon, Maalox, Mylanta, Phillips' Chewable Tablets, Rolaids, or TUMS (Take antacids 1 hour before or 2 hours after you take this medicine.)
• Antibiotics such as amoxicillin (Amoxil, Moxatag), amoxicillin/clavulanate potassium (Augmentin), ciprofloxacin (Cipro), dicloxacillin, metronidazole, penicillin, rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and sulfamethoxazole/trimethoprim (Bactrim, Septra)
• Antiviral medicines such as acyclovir (Zovirax), ganciclovir (Cytovene), valacyclovir (Valtrex), and valganciclovir (Valcyte)
• Cholesterol-lowering medicines such as cholestyramine (Prevalite) and colestipol (Colestid)
• Hormonal birth control implants, IUDs, patches, pills, shots, and vaginal rings, and hormones (Talk with your healthcare provider about effective birth control methods.)
• Immunosuppressants such as azathioprine (Azasan, Imuran), basiliximab (Simulect), cyclosporine (Gengraf, Neoral, Sandimmune), natalizumab (Tysabri), pimecrolimus (Elidel), sirolimus (Rapamune), and tacrolimus (Astagraf, Prograf, Protopic)
• Medicines to block or prevent stomach acid such as dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and rabeprazole (AcipHex)
• Natural remedies such as cat’s claw and echinacea
• Probenecid
• Sevelamer (Renagel, Renvela) (Take sevelamer 2 hours after you take this medicine.)
• Telmisartan (Micardis)
• Vaccines

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.