Myfortic (Mycophenolic Acid)

• Myfortic acts on the immune system to reduce lymphocyte‑mediated rejection and autoimmune activity.
• Kidney transplantation: prevention of organ rejection.
• Liver transplantation: prevention of organ rejection.
• Heart transplantation: prevention of organ rejection.
• Lupus nephritis: reduction of disease activity in this autoimmune kidney disorder.

• Mycophenolic acid selectively inhibits inosine monophosphate dehydrogenase (IMPDH), the key enzyme for de novo guanosine nucleotide synthesis in lymphocytes. This blockade reduces guanosine pools, impairing DNA synthesis and consequently inhibiting proliferation of T and B lymphocytes, leading to immunosuppression.

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

Common Side Effects

• Nausea: upset stomach and feeling of queasiness.
• Diarrhea: loose, frequent stools.
• Abdominal pain: discomfort or cramps in the stomach area.
• Headache: mild to moderate head pain.
• Upper respiratory infections: increased susceptibility to colds and sinusitis.
• Decreased white blood cell count: mild leukopenia detected in routine labs.

Serious or Rare Side Effects

• Severe infections: opportunistic or life‑threatening bacterial, viral, or fungal infections.
• Leukopenia or neutropenia: marked reduction in white blood cells increasing infection risk.
• Anemia: significant drop in red blood cells causing fatigue.
• Malignancy: rare reports of lymphoproliferative disorders or skin cancers.
• Progressive multifocal leukoencephalopathy (PML): extremely rare brain infection.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.

• Before initiating Myfortic, several safety considerations are recommended.
• Monitor blood counts: regular CBC to detect leukopenia or anemia.
• Assess renal function: dose may need adjustment in renal impairment.
• Avoid live vaccines: risk of infection due to immunosuppression.
• Pregnancy: drug is Category D; discuss risks with prescriber.
• Store at room temperature: keep below 25°C in the original pack, protect from moisture.

Myfortic can interact with other medicines, altering its efficacy or safety.

Major Interactions (Avoid)

• Cyclosporine: increased mycophenolic acid exposure.
• Strong CYP3A4 inhibitors (e.g., ritonavir): may raise drug levels.
• Live vaccines: heightened infection risk.

Moderate Interactions (Monitor Closely)

• Azathioprine: additive bone‑marrow suppression.
• Antacids or proton‑pump inhibitors: may reduce absorption of mycophenolic acid.
• Cholestyramine: can bind and lower drug bioavailability.