Mycophenolate Mofetil Accord (Mycophenolate Mofetil)

Mycophenolate Mofetil is employed in the management of immune‑mediated conditions, particularly where suppression of T‑ and B‑cell activity is required.

• Organ transplant rejection: reduces the risk of graft loss by inhibiting lymphocyte proliferation.
• Kidney transplant rejection: helps maintain graft function and prolong survival.
• Lupus nephritis: controls renal inflammation and slows disease progression.

• Mycophenolate Mofetil is converted intracellularly to mycophenolic acid, which selectively inhibits inosine monophosphate dehydrogenase. This blocks de novo guanosine nucleotide synthesis in lymphocytes, leading to reduced proliferation of T‑ and B‑cells and thereby dampening the immune response.

Mycophenolate Mofetil may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: frequent loose stools.
• Vomiting: occasional episodes.
• Abdominal pain: cramping or discomfort.
• Headache: transient mild pain.
• Infections: increased susceptibility to bacterial, viral or fungal infections.

Serious or Rare Side Effects

• Leukopenia: significant reduction in white blood cells.
• Anemia: decreased red blood cell count.
• Severe infections: opportunistic or life‑threatening infections.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Malignancy: increased risk of certain cancers.
• Progressive multifocal leukoencephalopathy: rare but serious brain infection.

Before initiating therapy, clinicians should assess patient-specific risk factors and monitor relevant parameters.

• Monitor blood counts: perform regular complete blood count testing.
• Monitor renal function: assess serum creatinine and glomerular filtration rate.
• Avoid in pregnancy: drug is contraindicated; ensure effective contraception.
• Use caution in breastfeeding: drug excreted in milk; generally not recommended.
• Adjust dose in renal impairment: consider reduced dosing in patients with decreased clearance.
• Store at below 25°C: keep in the original container, protect from moisture and direct sunlight.

Mycophenolate Mofetil interacts with several medicines that can alter its efficacy or safety.

Major Interactions (Avoid)

• Azathioprine: additive bone‑marrow suppression.
• Cyclosporine or tacrolimus: increased mycophenolic acid exposure.
• Live vaccines: risk of uncontrolled infection.
• Cholestyramine or colestipol: reduces absorption of mycophenolic acid.
• Antacids containing aluminum or magnesium: may decrease drug bioavailability.

Moderate Interactions (Monitor Closely)

• Warfarin: potential alteration of anticoagulant effect.
• ACE inhibitors or ARBs: monitor renal function and potassium.
• NSAIDs: increased risk of renal toxicity.
• Non‑live vaccines: monitor immune response.
• Rifampin: may reduce drug levels, requiring dose adjustment.