Mycophenolate Mofetil Sandoz (Mycophenolate Mofetil)

Mycophenolate Mofetil is used to modulate immune activity in conditions where T‑ and B‑cell proliferation must be controlled.

• Organ transplant rejection: reduces the risk of acute and chronic rejection after kidney, heart or liver transplantation.
• Lupus nephritis: improves renal outcomes and decreases proteinuria in patients with systemic lupus erythematosus.
• Other autoimmune diseases: may be employed where broad immunosuppression is required, such as certain vasculitides or severe connective‑tissue disorders.

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

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Gastrointestinal upset: nausea, vomiting, diarrhoea.
• Haematologic changes: leukopenia, anaemia, thrombocytopenia.
• Infections: increased susceptibility to bacterial, viral or fungal infections.
• Headache and fatigue.
• Elevated liver enzymes.

Serious or Rare Side Effects

• Severe infections such as opportunistic or reactivating infections.
• Progressive multifocal leukoencephalopathy (PML).
• Life‑threatening bone marrow suppression.
• Severe hypersensitivity reactions including Stevens‑Johnson syndrome.
• Pregnancy‑related complications and fetal toxicity.

Patients should be monitored closely for immunosuppression‑related complications and laboratory abnormalities.

• Baseline labs: obtain complete blood count and liver function tests before initiation.
• Infection risk: screen for latent tuberculosis and hepatitis before starting therapy.
• Vaccinations: avoid live vaccines while on treatment.
• Renal function: adjust monitoring in patients with impaired kidney function.
• Pregnancy and lactation: discuss potential risks with a healthcare professional.
• Store at ambient temperature below 25°C: keep in original container, protect from moisture and direct sunlight.

Mycophenolate Mofetil may interact with several drug classes, affecting its efficacy or safety.

Major Interactions (Avoid)

• Antimetabolites such as azathioprine: additive bone‑marrow suppression.
• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): markedly reduce exposure.
• Antacids containing aluminium or magnesium: decrease absorption if taken simultaneously.

Moderate Interactions (Monitor Closely)

• Calcineurin inhibitors (cyclosporine, tacrolimus): may increase mycophenolate levels.
• Proton‑pump inhibitors: may modestly reduce absorption; monitor therapeutic response.
• Vaccines: live attenuated vaccines should be avoided; inactivated vaccines may be given with caution.