FAQ: Mycophenolate

• Why is this medication being recommended?
• What special precautions should I follow?
• What side effects can this medication cause?
• What monitoring will I need?

Why is this medication being recommended?

Mycophenolate is part of a class of drugs called immunosuppressants. It suppresses the body's immune response and reduces inflammation in your lungs. Because inflammation is the precursor to fibrosis (scarring), we hope methotrexate will prevent the formation of lung fibrosis and allow the inflamed lung to return to normal.

What special precautions should I follow?

Before taking mycophenolate:

Tell your doctor and pharmacist if you are allergic to mycophenolate, mycophenolic acid, or any other medications.

Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking. Be sure to mention any of the following:

• Acetazolamide (Diamox)
• Acyclovir (Zovirax)
• Antibiotics
• Azathioprine (Imuran)
• Chlorothiazide (Diuril)
• Cimetidine (Tagamet)
• Cholestyramine (Questran)
• Colestipol (Colestid)
• Ethacrynic acid (Edecrin)
• Furosemide (Lasix)
• Ganciclovir (Cytovene)
• Isoproterenol (Isuprel)
• Meperidine (Demerol)
• Morphine (MS Contin, MSIR, Oramorph)
• Oral contraceptives (birth control pills)
• Phenytoin (Dilantin)
• Probenecid (Benemid)
• Procainamide (Pronestyl)
• Quinine
• Salicylate pain relievers such as aspirin, choline magnesium trisalicylate (Trisalate), choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others) and salsalate (Argesic, Disalcid, Salgesic)
• Theophylline (TheoDur)

Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you are pregnant, plan to become pregnant or are breast-feeding. You must use two forms of birth control before beginning treatment with mycophenolate, during treatment and for six weeks after treatment. Your doctor will not allow you to begin taking mycophenolate unless you have had a negative pregnancy test. If you become pregnant while you are taking mycophenolate, call your doctor immediately. Do not breast-feed while you are taking this medication.

Tell your doctor if you have or have ever had Lesch-Nyhan or Keeley-Seegmiller syndrome (inherited diseases that cause high levels of a certain substance in the blood, joint pain and problems with motion and behavior); any disease that affects your stomach, intestines or digestive system; any type of cancer; phenylketonuria (an inherited diseases that requires patients to follow a special diet to prevent mental retardation); or liver or kidney disease. If you have phenylketonuria, or PKU, you should know that mycophenolate liquid may be sweetened with aspartame, which forms phenylalanine.

While on mycophenalate:

• If you are taking antacids, take them two hours before or four hours after taking mycophenolate.
• Tell your doctor if you experience vision problems, loss of coordination or memory loss, which could be signs Progressive Multifocal Leukoencephalopathy (PML), a potential complication of taking mycophenolate.
• If you become pregnant, tell your doctor immediately.
• Do not get any vaccinations, either from shots or nasal spray, without consulting with your doctor.

What side effects can this medication cause?

Mycophenolate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• Constipation
• Diarrhea
• Difficulty falling asleep or staying asleep
• Pain, especially in the back, muscles or joints
• Stomach pain
• Upset stomach
• Vomiting

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or any of the symptoms listed in the important warning section of the medication insert, call your doctor immediately:

• Black and tarry stools
• Bloody vomit
• Difficulty breathing
• Dizziness
• Excessive tiredness
• Fast heartbeat
• Headache
• Loose, floppy muscles
• Pale skin
• Rash
• Red blood in stools
• Shaking hands that you cannot control
• Swelling of gums
• Swelling of the hands, feet, ankles or lower legs
• Unusual bruising or bleeding
• Vision changes
• Vomiting material that looks like coffee grounds
• Weakness
• White patches in mouth or throat

Mycophenolate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What monitoring will I need?

Your doctor will order regular lab tests to check your response to mycophenolate and monitor for toxicity. You will need to have your blood counts — white blood cells, red blood cells and platelets — checked regularly. Your doctor may order additional tests depending on the results.

For additional information on mycophenolate, please visit MedlinePlus.gov.