Myfortic (Mycophenolic Acid)

Myfortic is an antimetabolite immunosuppressant used in solid‑organ transplantation to inhibit lymphocyte proliferation.

• Renal transplant: helps prevent graft rejection in kidney recipients.
• Cardiac transplant: reduces the incidence of heart‑graft rejection.
• Liver transplant: supports long‑term graft survival by suppressing immune response.

• Mycophenolic acid selectively inhibits inosine monophosphate dehydrogenase (IMPDH), a key enzyme in the de novo synthesis of guanosine nucleotides. By limiting guanosine availability, the drug suppresses proliferation of activated T and B lymphocytes, which rely heavily on this pathway, thereby dampening the immune response that leads to organ rejection.

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

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Diarrhea: frequent loose stools.
• Vomiting: occasional emesis.
• Abdominal pain: cramping or discomfort.
• Headache: transient mild headache.
• Increased infection risk: higher susceptibility to common 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 with long‑term use.
• Gastrointestinal perforation: rare but serious bowel injury.

Patients receiving Myfortic should be monitored closely for safety and efficacy.

• Blood counts: monitor complete blood count regularly to detect leukopenia or anemia.
• Liver function: assess hepatic enzymes periodically.
• Live vaccines: avoid administration while on therapy due to immunosuppression.
• Renal function: adjust dosing in patients with impaired kidney function.
• Infection signs: report fever, cough, or unusual symptoms promptly.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Myfortic can interact with several medicines, altering its effectiveness or safety profile.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: may reduce absorption of mycophenolic acid.
• Cholestyramine or colestipol: can bind the drug and lower systemic exposure.
• Cyclosporine or tacrolimus: may increase mycophenolic acid levels, raising toxicity risk.

Moderate Interactions (Monitor Closely)

• Azathioprine: additive bone‑marrow suppression; monitor blood counts closely.
• Live attenuated vaccines: heightened infection risk; consider alternative immunizations.