Read the Medication Guide that comes with mycophenolate mofetil 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 treatment.
What is the most important information I should know about mycophenolate mofetil? Mycophenolate mofetil can cause serious side effects, including:
Increased risk of loss of a pregnancy (miscarriage) and higher risk of birth defects. Females who take mycophenolate mofetil 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.
Increased risk of getting certain cancers. People who take mycophenolate mofetil have a higher risk of getting lymphoma, and other cancers, especially skin cancer. Tell your doctor if you have:
- unexplained fever, prolonged tiredness, weight loss or lymph node swelling
- a brown or black skin lesion with uneven borders, or one part of the lesion does not look like the other
- a change in the size and color of a mole
- a new skin lesion or bump
- any other changes to your health
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 and can lead to hospitalizations and death. These serious infections can include:
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 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 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. Call your doctor right away if you have any of the following symptoms:
- weakness on one side of the body
- you do not care about things you usually care about (apathy)
- you are confused or have problems thinking
- you cannot control your muscles
Fungal infections. Yeasts and other types of fungal infections can happen with mycophenolate mofetil and can cause serious tissue and blood infections (See “What are the possible side effects of mycophenolate mofetil?”).
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
See “What are the possible side effects of mycophenolate mofetil?” for information about other serious side effects.
What is mycophenolate mofetil?
- Mycophenolate mofetil is 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 is used with other medicines containing cyclosporine and corticosteroids.
Who should not take mycophenolate mofetil?
Do not take mycophenolate mofetil if you are allergic to mycophenolate mofetil or any of the ingredients in mycophenolate mofetil. See the end of this Medication Guide for a complete list of ingredients in mycophenolate mofetil.
What should I tell my doctor before taking mycophenolate mofetil?
Tell your doctor about all of your medical conditions, including if you:
- have any digestive problems, such as ulcers.
- have Lesch-Nyhan syndrome, Kelley-Seegmiller syndrome, or another rare inherited deficiency hypoxanthine-guanine phosphoribosyl-transferase (HGPRT). You should not take mycophenolate mofetil if you have one of these disorders.
- plan to receive any vaccines. People taking mycophenolate mofetil should not receive live vaccines. Some vaccines may not work as well during treatment with mycophenolate mofetil.
- are pregnant or plan to become pregnant. See “What is the most important information I should know about mycophenolate mofetil?”
- 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 or breastfeed.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Some medicines may affect the way mycophenolate mofetil works, and mycophenolate mofetil may affect how some medicines work.
Especially tell your doctor if you take:
- birth control pills (oral contraceptives). See “What is the most important information I should know about mycophenolate mofetil?”
- sevelamer (Renagel®, Renvela™). These products should be taken at least 2 hours after taking mycophenolate mofetil.
- acyclovir (Zovirax®), valacyclovir (Valtrex®), ganciclovir (CYTOVENE®-IV, Vitrasert®), valganciclovir (VALCYTE®).
- rifampin (Rifater®, Rifamate®, Rimactane®, Rifadin®).
- antacids that contain magnesium and aluminum (mycophenolate mofetil 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?
- Take mycophenolate mofetil exactly as prescribed.
- Do not stop taking mycophenolate mofetil or change the dose unless your doctor tells you to.
- If you miss a dose of mycophenolate mofetil, or you are not sure when you took your last dose, take your prescribed dose of mycophenolate mofetil as soon as you remember. If your next dose is less than 2 hours away, 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.
- 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?
- Avoid becoming pregnant. See “What is the most important information I should know about mycophenolate mofetil?”
- Limit the amount of time you spend in sunlight. Avoid using tanning beds or sunlamps. People who take mycophenolate mofetil have a higher risk of getting skin cancer (See “What is the most important information I should know about mycophenolate mofetil?”). Wear protective clothing when you are in the sun and use a broad-spectrum sunscreen with a high protection factor. This is especially important if your skin is very fair or if you have a family history of skin cancer.
- You should not donate blood while taking mycophenolate mofetil and for at least 6 weeks after stopping mycophenolate mofetil.
- You should not donate sperm while taking mycophenolate mofetil and for 90 days after stopping mycophenolate mofetil.
- Mycophenolate mofetil may influence your ability to drive and use machines (See “What are the possible side effects of mycophenolate mofetil?”. If you experience drowsiness, confusion, dizziness, tremor, or low blood pressure during treatment with mycophenolate mofetil, you should be cautious about driving or using heavy machines.
What are the possible side effects of mycophenolate mofetil? Mycophenolate mofetil can cause serious side effects, including:
- See “What is the most important information I should know about mycophenolate mofetil?”
Low blood cell counts. People taking high doses of mycophenolate mofetil each day may have a decrease in blood counts, including:
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 1 month to 6 months after your transplant.
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.
platelets. Platelets help with blood clotting.
Your doctor will do blood tests before you start taking mycophenolate mofetil and during treatment with mycophenolate mofetil to check your blood cell counts. Tell your doctor right away if you have any signs of infection (See “What is the most important information I should know about mycophenolate mofetil?”), including any unexpected bruising or bleeding. Also, tell your doctor if you have unusual tiredness, lack of energy, dizziness or fainting.
Stomach problems. Stomach problems including intestinal bleeding, a tear in your intestinal wall (perforation) or stomach ulcers can happen in people who take mycophenolate mofetil. Bleeding can be severe and you may have to be hospitalized for treatment. Call your doctor right away if you have sudden or severe stomach-area pain or stomach-area pain that does not go away, or if you have diarrhea.
The most common side effects of mycophenolate mofetil include:
- blood problems including low white and red blood cell counts
- blood pressure problems
- fast heart beat
- swelling of the lower legs, ankles and feet
- changes in laboratory blood levels, including high levels of blood sugar (hyperglycemia)
- stomach problems including diarrhea, constipation, nausea and vomiting
- nervous system problems such as headache, dizziness and tremor
Side effects that can happen more often in children than in adults taking mycophenolate mofetil include:
- stomach area pain
- blood infection (sepsis)
- sore throat
- colds (respiratory tract infections)
- high blood pressure
- low white blood cell count
- low red blood cell count
These are not all of the possible side effects of mycophenolate mofetil. 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 FDA at 1-800-FDA-1088. You may also report side effects to Akorn, Inc. at 1-800-932-5676.
How should I store mycophenolate mofetil?
Keep mycophenolate mofetil and all medicines out of the reach of children.
General Information about the safe and effective use of mycophenolate mofetil.
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use mycophenolate mofetil for a condition for which it was not prescribed. Do not give mycophenolate mofetil 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. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about mycophenolate mofetil that is written for health professionals.
What are the ingredients in mycophenolate mofetil for injection?
Active Ingredient: mycophenolate mofetil
Inactive Ingredients: polysorbate 80 and citric acid. Sodium hydroxide may have been used in the manufacture of mycophenolate mofetil for injection to adjust the pH.
This Medication Guide has been approved by the U.S. Food and Drug Administration.
All product names, trademarks and registered trademarks are the property of their respective owners.
Novaplus is a registered trademark of Vizient, Inc.
Manufactured by: Akorn, Inc.
Lake Forest, IL 60045
NMM00N Rev. 02/20
For additional copies of this Medication Guide, please call Akorn at 1-800-932-5676 or visit www.akorn.com.