By DR. MICHAEL J. DEVLIN, NEUROLOGIST:
Mycophenolate is an immunosuppressant taken to treat many autoimmune conditions including several neurological diseases, and to prevent organ rejection following transplantation. It reduces the production of activated white cells in the body – those cells that cause myasthenia gravis. By reducing white cells, mycophenolate increases the risk of opportunistic infections, and blood tests are required to ensure that the white cell count isn’t too low.
There are two formulations of mycophenolate: mycophenolate mofetil (Ceptolate, CellCept, Mycocept) and mycophenolate enteric coated (Myfortic). These drugs are not the same and it is important not to change between them inadvertently. There are advantages and disadvantages with each that will influence your specialist’s choice of formulation.
Mycophenolate may have side effects for some people. Gastrointestinal side effects (diarrhoea, vomiting, abdominal cramping) are common, especially when taking mycophenolate for the first time – usually these side effects subside with over weeks, but rarely the medication dose may need to be reduced, or ceased completely. Other side effects include bone marrow suppression (anaemia, low white cell count), infections (pneumonia and viral infections most common) and a higher risk of cancer in the long term. Mycophenolate should not be taken during pregnancy or breastfeeding. Condoms should be used if you are as a sexually active man taking mycophenolate.
Some medications interact with mycophenolate including antacids, hormonal contraception and some antibiotics. Some are not ideal to take; others need to be taken a few hours apart from mycophenolate. Talk to your doctor or pharmacist about your other medications and any potential interactions.
LEARNING BITE (by Dr Fiona Chan)
Even though there has been some evidence in the literature looking at the interaction between taking Mycophenolate tablets with calcium supplements, the interaction with calcium rich food, is however, less well studied. The effects are unlikely to be drastic, as long as reasonable caution is exercised such as avoiding taking it with a tall glass of milk. As with any medication prescribed twice daily, taking it at regular intervals is encouraged but what is more important than strict on-the-dot administration is merely remembering to take the medications as drug levels will be affected if tablets are missed. In other words, better late than never!