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Overview: Mycophenolate is used to help prevent your immune system from attacking a new organ after a transplant. Common side effects include diarrhea and infections. Mycophenolate may increase your risk of cancer. If you need to be in sunlight, then wear sunscreen, a hat, or clothing that covers your skin to reduce this risk. Call your health care provider right away if you have unusual tiredness, stomach pain, fever, joint pain, muscle pain, or unusual bleeding or bruising.

Uses

What is mycophenolate used for?

Mycophenolate is commonly used to prevent organ rejection after a kidney, heart, or liver transplant. Organ rejection can happen if your immune system sees the new organ as something that does not belong in your body and attacks it.

Mycophenolate may also be used for other conditions as determined by your health care provider.

How does mycophenolate work (mechanism of action)?

Mycophenolate works by weakening the immune system and making immune cells less active. This lowers the risk of your immune system attacking your new organ after a transplant.

How is mycophenolate supplied (dosage forms)?

Brands and other names

  • Cellcept
  • Myfortic
  • Myhibbin

Dosage forms and strengths

  • 250 mg oral capsules
  • 200 mg/mL oral suspension
  • 500 mg oral tablets
  • 180 mg, 360 mg delayed-release oral tablets

Mycophenolate is also available in injectable forms.

How should I store mycophenolate?

Oral Tablets and Capsules. Mycophenolate tablets and capsules should be stored at room temperature, between 59 F and 86 F (15 C and 30 C). Store in a cool, dry place and keep protected from light.

Oral Liquid. Mycophenolate liquid should be stored at room temperature, between 59 F and 86 F (15 C and 30 C). Store in a cool, dry place. Do not freeze. Mycophenolate liquid that your health care provider mixes for you needs to be thrown away after 60 days and may be kept in a refrigerator between 36 F and 46 F (2 C and 8 C). Ask your pharmacist if you have any questions.

Injection Liquid. Mycophenolate injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of mycophenolate?

The most common side effects of mycophenolate are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Diarrhea
  • Blood disorders (see below)
  • Infections (see below)
  • Vomiting

There may be other side effects of mycophenolate that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada or by calling 866-234-2345.

What are the serious side effects of mycophenolate?

While less common, the most serious side effects of mycophenolate are described below, along with what to do if they happen.

Severe Allergic Reactions. Mycophenolate may cause allergic reactions, which can be serious. Get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Blood Disorders. Mycophenolate can cause blood cell disorders, such as low white blood cell levels (neutropenia), low platelet levels (thrombocytopenia), and low red blood cell levels (anemia). It is also possible to develop pure red cell aplasia, which is when your body does not make enough red blood cells. Keep all appointments to have your blood checked while using mycophenolate. Call your health care provider right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or unusual bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Infections. Mycophenolate reduces your ability to fight off infections and increases your risk of serious infections. Mycophenolate may also cause a past viral infection, such as hepatitis B, hepatitis C, or cytomegalovirus, to become active again. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Fever, sweats, chills, or muscle aches
  • Feeling more tired than usual
  • Sore throat
  • Cough or coughing up blood
  • Burning or stinging when you pee
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss
  • Loss of appetite
  • White patches in your mouth or throat
  • Skin sores or cuts that look red, discolored, or ooze pus
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Progressive Multifocal Leukoencephalopathy (PML). People using mycophenolate may develop a brain disease called PML. It is caused by a virus called the JC virus. While rare, PML is very serious and can lead to death. Call your health care provider right away if you have any of the following symptoms of PML.

  • Clumsiness or loss of coordination
  • Difficulty walking or speaking
  • Facial drooping
  • Vision problems
  • Thinking, memory, or personality changes
  • Weakness on one side of your body that gets worse
  • Seizures

Cancer. Mycophenolate can cause a new cancer to develop, including certain blood cancers (lymphomas) or skin cancer. It may also cause a previously treated cancer to come back. If you need to be in sunlight, then wear sunscreen, a hat, and clothing that covers your skin. Keep all appointments, including those for lab work. Tell your health care provider about any new symptoms or skin changes.

Stomach Bleeding. Mycophenolate may cause bleeding, ulcers, or tears (perforation) in your stomach or gut. Get help right away if you have any of the following symptoms.

  • Vomiting blood
  • Black or tarry poop
  • Sudden stomach pain, or stomach pain that does not go away
  • Upset stomach

Sudden Inflammation. Acute inflammatory syndrome (AIS) is a rare inflammatory reaction to mycophenolate that can happen within weeks to months after starting treatment or increasing the dose. Normally, medicines like mycophenolate help to reduce inflammation, but AIS is when the opposite happens, and the medicine causes the body to react with more inflammation instead of less. Tell your health care provider right away if you develop the following symptoms of AIS.

  • Fever
  • Muscle pain
  • Swollen, stiff, or painful joints

Warnings & Precautions

Who should not use mycophenolate?

Allergies to Ingredients. People who are allergic to any of the following should not take mycophenolate.

  • Cellcept
  • Mycophenolate mofetil
  • Mycophenolic acid 
  • Myfortic
  • Myhibbin
  • Polysorbate 80 (injection only)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific mycophenolate products they stock.

What should I know about mycophenolate before using it?

Do not use mycophenolate unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share mycophenolate with other people, even if they have the same condition as you. It may harm them.

Keep mycophenolate out of the reach of children. Since mycophenolate oral liquid that your pharmacist mixes for you may be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Follow the Instructions for Use provided with mycophenolate oral liquid for directions on how to measure, mix, and take it. Shake the bottle well before each dose. Only use the oral dispenser that comes with this medicine to measure your dose. Do not use a household spoon as it is not an accurate measuring device and may cause you to give the wrong dose.

Do not crush, cut, or chew mycophenolate tablets. Do not crush or open mycophenolate capsules. Swallow the whole tablets or capsules.

If mycophenolate touches your skin, wash the area with soap and water right away. If the medicine gets in your eye, flush with plain water right away.

Mycophenolate can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how mycophenolate affects you.

Do not donate blood while using mycophenolate and for at least six weeks after your last dose. Do not donate sperm while using mycophenolate and for at least 90 days after your last dose.

You should avoid becoming pregnant or getting your partner pregnant while taking this medicine and for some time after. If you or your partner can become pregnant, talk with your health care provider about your birth control options and how long you should use them. You may need to use more than one method of birth control. Ask your health care provider if you have any questions.

What should I tell my health care provider before using mycophenolate?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if mycophenolate is right for you.

In particular, make sure that you discuss any of the following.

Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while using mycophenolate. Tell your health care provider about any vaccines you have recently received or have scheduled.

Other Medicines and Supplements. Mycophenolate may interact with other medicines and supplements. Before starting mycophenolate, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Enzyme Deficiency. Tell your health care provider if you have an inherited condition known as Lesch-Nyhan syndrome, Kelley-Seegmiller syndrome, or HGPRT deficiency. Using mycophenolate could make the symptoms of these conditions worse. Your health care provider can help determine if mycophenolate is safe for you.

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Gut problems, such as stomach ulcers
  • Infections
  • ​​Phenylketonuria (oral liquid may contain aspartame)
  • Skin cancer or a family history of skin cancer

Pregnancy. Mycophenolate can cause harm to a fetus. You should not be pregnant before starting mycophenolate. If you can become pregnant, talk to your health care provider about your birth control options. Tell your health care provider right away if you become pregnant during or within six weeks after stopping mycophenolate. If you become pregnant while taking this medicine or within six weeks of your last dose, you can register for a pregnancy registry by calling 800-617-8191 or visiting www.mycophenolateREMS.com. This registry collects safety information about the use of mycophenolate during pregnancy.

Breastfeeding. Mycophenolate passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take mycophenolate while breastfeeding.

Interactions

Does mycophenolate interact with foods or drinks?

Mycophenolate capsules, tablets, and oral liquid should be taken on an empty stomach, unless your health care provider tells you to take it with food. Take mycophenolate either one hour before or two hours after eating.

It is unknown if drinking alcohol will affect mycophenolate, but heavy drinking can slow your immune response and make it harder for your body to fight infections. Infections, including some serious infections, are a possible side effect of mycophenolate. See the Side Effects section for more details.

Does mycophenolate interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 In particular, make sure that you discuss if you are using any of the following before using mycophenolate.

  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD) that contains hormones
  • An antacid containing aluminum or magnesium
  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • Sulfamethoxazole/trimethoprim or any other antibiotic, which is used to treat certain infections
  • A bile acid sequestrant, such as cholestyramine (Prevalite), colesevelam (Welchol), or colestipol (Colestid), which is a medicine to lower cholesterol
  • ​​Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Acyclovir (Zovirax), ganciclovir, valacyclovir (Valtrex) or valganciclovir (Valcyte), which is used to treat certain viral infections
  • Sevelamer (Renagel, Renvela), which is a phosphate binder medicine used for certain kidney problems
  • Telmisartan (Micardis), which is a medicine for high blood pressure
  • Azathioprine (Azasan, Imuran), which is a medicine used for rheumatoid arthritis and prevention of kidney transplant rejection

Many other medicines may alter the blood levels of mycophenolate and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with mycophenolate. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much mycophenolate?

If you or someone else has used too much mycophenolate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of mycophenolate?

Missing doses of mycophenolate can cause it to not work as well over time. So it is important not to miss or skip doses.

Oral Tablets, Capsules, and Liquid. If you miss a dose, take it as soon as you remember. However, if it is less than two hours until your next dose is due, skip the missed dose and only take the next one. Do not take double or extra doses.

Injection. Mycophenolate injection is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving mycophenolate as scheduled.

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