MYCOPHENOLATE MOFETIL- mycophenolate mofetil capsule 
Sandoz Inc

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Medication Guide

Mycophenolate Mofetil Capsules, USP

Read the Medication Guide that comes with mycophenolate mofetil capsules before you start taking it and each time you refill your prescription. There may be new information. This Medication Guide does not take the place of talking with your doctor about your medical condition or your treatment.

What are the most important information I should know about mycophenolate mofetil capsules?

Mycophenolate mofetil capsules can cause serious side effects:

Increased risk of loss of a pregnancy (miscarriage) and higher risk of birth defects. Females who take mycophenolate mofetil capsules during pregnancy have a higher risk of miscarriage during the first 3 months (first trimester), and a higher risk that their baby will be born with birth defects.

If you are a female who can become pregnant

your doctor must talk with you about acceptable birth control methods (contraceptive counseling) to use while taking mycophenolate mofetil capsules.
you should have one pregnancy test immediately before starting mycophenolate mofetil capsules and another pregnancy test 8 to 10 days later. Pregnancy tests should be repeated during routine follow-up visits with your doctor. Talk to your doctor about the results of all of your pregnancy tests.
you must use acceptable birth control, during your entire mycophenolate mofetil capsules therapy and for 6 weeks after stopping mycophenolate mofetil capsules, unless at any time you choose to avoid sexual intercourse (abstinence) with a man completely.
 
Mycophenolate mofetil capsules decreases blood levels of the hormones in birth control pills that you take by mouth. Birth control pills may not work as well while you take mycophenolate mofetil capsules, and you could become pregnant. If you take birth control pills while using mycophenolate mofetil capsules you must also use another form of birth control. Talk to your doctor about other birth control methods that you can use while taking mycophenolate mofetil capsules.
 
If you plan to become pregnant, talk with your doctor. Your doctor will decide if other medicines to prevent rejection may be right for you.
 
If you become pregnant while taking mycophenolate mofetil capsules, do not stop taking mycophenolate mofetil capsules. Call your doctor right away. In certain situations, you and your doctor may decide that taking mycophenolate mofetil capsule is more important to your health than the possible risks to your unborn baby.
You and your doctor should report your pregnancy to
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Mycophenolate Pregnancy Registry 1-800-617-8191
 
The purpose of this registry is to gather information about the health of you and your baby.
Increased risk of getting serious infections. Mycophenolate mofetil weakens the body's immune system and affects your ability to fight infections. Serious infections can happen with mycophenolate mofetil capsules and can lead to death. These serious infections can include:
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Viral infections. Certain viruses can live in your body and cause active infections when your immune system is weak. Viral infections that can happen with mycophenolate mofetil capsules include:
Shingles, other herpes infections, and cytomegalovirus (CMV). CMV can cause serious tissue and blood infections.
BK virus. BK virus can affect how your kidney works and cause your
transplanted kidney to fail.
Hepatitis B and C viruses. Hepatitis viruses can affect how your liver works. Talk to your doctor about how hepatitis viruses may affect you.
A brain infection called Progressive Multifocal Leukoencephalopathy (PML). In some patients, mycophenolate mofetil capsules may cause an infection of the brain that may cause death. You are at risk for this brain infection because you have a weakened immune system. You should tell your doctor right away if you have any of the following symptoms:
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Weakness on one side of the body
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You do not care about things that you usually care about (apathy)
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You are confused or have problems thinking
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You cannot control your muscles
Fungal infections. Yeasts and other types of fungal infections can happen with mycophenolate mofetil capsules and can cause serious tissue and blood infections (see “What are the possible side effects of mycophenolate mofetil capsules?”)

Call your doctor right away if you have any of the following signs and symptoms of infection:

Temperature of 100.5°F or greater
Cold symptoms, such as a runny nose or sore throat
Flu symptoms, such as an upset stomach, stomach pain, vomiting or diarrhea
Earache or headache
Pain during urination
White patches in the mouth or throat
Unexpected bruising or bleeding
Cuts, scrapes or incisions that are red, warm and oozing pus
Increased risk of getting certain cancers. People who take mycophenolate mofetil capsules have a higher risk of getting lymphoma, and other cancers, especially skin cancer. Tell your doctor if you have:
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unexplained fever, prolonged tiredness, weight loss or lymph node swelling.
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a brown or black skin lesion with uneven borders, or one part of the lesion does not look like the other
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a change in the size and color of a mole
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a new skin lesion or bump
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any other changes to your health

See the section “What are the possible side effects of mycophenolate mofetil capsules ?” for information about other serious side effects.

What are mycophenolate mofetil capsules?

Mycophenolate mofetil capsules are a prescription medicine to prevent rejection (antirejection medicine) in people who have received a kidney, heart or liver transplant. Rejection is when the body's immune system perceives the new organ as a “foreign” threat and attacks it.

Mycophenolate mofetil capsules are used with other medicines called cyclosporines (Sandimmune®, Gengraf®, Neoral®) and corticosteroids.

Mycophenolate mofetil capsules have been used safely and works in children who received a kidney transplant as it does in adults. It is not known if mycophenolate mofetil capsules are safe and works in children who receive a heart or liver transplant.

Who should not take mycophenolate mofetil capsules?

Do not take mycophenolate mofetil capsules if you are allergic to mycophenolate mofetil capsules or any of the ingredients in mycophenolate mofetil capsules. See the end of this Medication Guide for a complete list of ingredients in mycophenolate mofetil capsules.

What should I tell my doctor before taking mycophenolate mofetil capsules?

Tell your doctor about all of your medical conditions, if you:

have any digestive problems, such as ulcers
have Lesch-Nyhan or Kelley-Seegmiller syndrome or another rare inherited deficiency hypoxanthine-guanine phosphoribosyl-transferase (HGPRT). You should not take mycophenolate mofetil capsules if you have one of these disorders
plan to receive any vaccines. People taking mycophenolate mofetil capsules should not take live vaccines. Some vaccines may not work as well during treatment with mycophenolate mofetil capsules
are pregnant or are planning to become pregnant. See “What are the most important information I should know about mycophenolate mofetil capsules?”
are breastfeeding or plan to breastfeed. It is not known if mycophenolate mofetil passes into breast milk. You and your doctor will decide if you will take mycophenolate mofetil capsules or breastfeed.

Tell your healthcare provider about all the medicines you are taking including prescription and nonprescription medicines, vitamins and herbal supplements. Some medicines may affect the way mycophenolate mofetil capsules works, and mycophenolate mofetil capsules may affect how some medicines work. Especially tell your doctor if you take:

birth control pills (oral contraceptives). See “What are the most important information I should know about mycophenolate mofetil capsules?”
sevelamer (Renagel®, Renvela™). These products should be taken 2 hours after taking mycophenolate mofetil capsule
acyclovir (Zovirax®), valacyclovir (Valtrex®), ganciclovir (CYTOVENE® –IV, Vitrasert®) valganciclovir (VALCYTE®)
rifampin (Rifater®, Rifamate®, Rimactane®, Rifadin®)
antacids that contain magnesium and aluminum (mycophenolate mofetil capsules and the antacid should not be taken at the same time)
proton pump inhibitors (PPIs) (Prevacid®, Protonix®)
sulfamethoxazole/trimethoprim (BACTRIM™, BACTRIM DS™)
norfloxacin (Noroxin®) and metronidazole (Flagyl®, Flagyl® ER, Flagyl® IV, Metro IV, Helidac®, Pylera™)
ciprofloxacin (Cipro®, Cipro® XR, Ciloxan®, Proquin® XR) and amoxicillin plus clavulanic acid (Augmentin®, Augmentin XR™)
azathioprine (Azasan®, Imuran®)
cholestyramine (Questran Light®, Questran®, Locholest Light, Locholest, Prevalite®)

Know the medicines you take. Keep a list of them to show to your doctor or nurse and pharmacist when you get a new medicine. Do not take any new medicine without talking with your doctor.

How should I take mycophenolate mofetil capsules?

Take mycophenolate mofetil capsules exactly as prescribed
Do not stop taking mycophenolate mofetil capsules or change the dose unless your doctor tells you to.
If you miss a dose of mycophenolate mofetil capsules, or are not sure when you took your last dose, take the regular amount of mycophenolate mofetil capsules prescribed as soon as you remember. If it is time for your next dose, skip the missed dose and take your next dose at your normal scheduled time. Do not take 2 doses at the same time. Call your doctor if you are not sure what to do.
Take mycophenolate mofetil capsules on an empty stomach, either 1 hour before or 2 hours after a meal, unless your healthcare provider tells you otherwise. With the approval of your healthcare provider, in stable kidney transplant patients, mycophenolate mofetil capsules can be taken with food if necessary.
Most people take mycophenolate mofetil capsules by mouth either as opaque blue and white capsules. Some people may get mycophenolate mofetil capsules soon after their transplant surgery as an infusion into a vein.
Do not open or crush mycophenolate mofetil capsules.
If you are not able to swallow mycophenolate mofetil capsules, your doctor may prescribe mycophenolate mofetil oral suspension. This is a liquid form of mycophenolate mofetil. Your pharmacist will mix the medicine before giving it to you.
If you take too much mycophenolate mofetil, call your doctor or the poison control center right away.

What should I avoid while taking mycophenolate mofetil capsules?

Avoid pregnancy. See “What is the most important information I should know about mycophenolate mofetil capsules?”
Limit the amount of time you spend in sunlight. Avoid using tanning beds or sunlamps. People who take mycophenolate mofetil capsules have a higher risk of getting skin cancer. (See “What are the most important information I should know about mycophenolate mofetil capsules?”) Wear protective clothing when you are in the sun and use a sunscreen with a high protection factor (SPF 30 and above). This is especially important if your skin is very fair or if you have a family history of skin cancer.

What are the possible side effects of mycophenolate mofetil capsules?

Mycophenolate mofetil capsules can cause serious side effects:

See “What are the most important information I should know about mycophenolate mofetil capsules?”

Low blood cell counts. People taking high doses of mycophenolate mofetil capsules each day may have a decrease in blood counts, including:
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white blood cells, especially neutrophils. Neutrophils fight against bacterial infections. You have a higher chance of getting an infection when your white blood cell count is low. This is most common from 3 months to 6 months after your transplant.
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red blood cells. Red blood cells carry oxygen to your body tissues. You have a higher chance of getting severe anemia when your red blood cell count is low.
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platelets. Platelets help with blood clotting.

Your doctor will do blood tests before you start taking mycophenolate mofetil capsules and during treatment with mycophenolate mofetil capsules to check your blood cell counts.

Tell your doctor right away if you have any signs of infection (see “What are the most important information I should know about mycophenolate mofetil capsules?”), or unexpected bruising or bleeding. Also, tell your doctor if you have unusual tiredness, lack of energy, dizziness or fainting.

Stomach problems. Stomach and intestinal bleeding can happen in people who take high doses of mycophenolate mofetil capsules. Bleeding can be severe and you may have to be hospitalized for treatment.

Common side effects include:

diarrhea. Call your doctor right away if you have diarrhea. Do not stop taking mycophenolate mofetil capsules without first talking with your doctor.
Vomiting.
Pain.
stomach area pain.
swelling of the lower legs, ankles and feet.
high blood pressure.

Side effects that happen more often in children than in adults taking mycophenolate mofetil capsules include:

stomach area pain
vomiting
fever
sore throat
infection
colds (respiratory tract infections)
pain
high blood pressure
blood infection (sepsis)
low white blood cell count
diarrhea
low red blood cell count

These are not all of the possible side effects to mycophenolate mofetil capsules. Tell your doctor about any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088 or Sandoz at 1-800-525-5747.

How should I store mycophenolate mofetil capsules?

Store mycophenolate mofetil capsules at 20º to 25°C (68º to 77°F). Keep the container closed tightly.
Keep mycophenolate mofetil capsules and all medicines out of the reach of children

General Information about mycophenolate mofetil capsules

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use mycophenolate mofetil capsules for a condition for which it was not prescribed. Do not give mycophenolate mofetil capsules to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about mycophenolate mofetil capsules. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about mycophenolate mofetil capsules that is written for healthcare professionals. For more information call 1-800-525-8747.

What are the ingredients in mycophenolate mofetil capsules?

Active Ingredient: mycophenolate mofetil

Inactive Ingredients: croscarmellose sodium, FD&C blue #2, gelatin, magnesium stearate, povidone (K-90), pregelatinized starch and titanium dioxide, butyl alcohol, black iron oxide, dehydrated alcohol, isopropyl alcohol, potassium hydroxide, propylene glycol, purified water, shellac and strong ammonia solution.

This Medication Guide has been approved by the U.S. Food and Drug Administration.

The brands listed are trademarks of their respective owners and are not trademarks of Sandoz Inc.

Manufactured in India by Sandoz Private Ltd.

for Sandoz Inc., Princeton, NJ 08540

Rev. August 2013

Revised: 08/2013
 
Sandoz Inc