Mycophenolate
Dosage and monitoring record for
patients with interstitial lung disease
This booklet contains information about your immunosuppressant
treatment. Keep this booklet with you at all times and show it to
those treating you, such as your doctor, pharmacist and nurse.
Important information
This booklet gives some information about your medicine. It is not intended
to be exhaustive and should not be used as a substitute for consulting with
your doctor on any particular issue. If you have further questions, please ask
your doctor, pharmacist or nurse.
Take this medicine only as prescribed by your doctor. Do not change anything
without checking with your doctor first.
This medicine has been prescribed for you only. Do not give it to anyone,
even if their symptoms are the same as yours.
What is mycophenolate mofetil (brand name: Cell-Cept)?
Mycophenolate is an immunosuppressant drug that is used to control your
body’s immune system in conditions where it is overactive and reacting
against your own body. Examples include:
• Organ transplant: to prevent the body rejecting a new organ.
• Lung disease: to reduce the inflammation that may contribute to symptoms
of breathlessness and reduced exercise tolerance. If you are already taking
prednisolone therapy, starting mycophenolate may mean that your dose of
prednisolone can be reduced.
• Inflammatory conditions: for example rheumatoid arthritis.
We have prescribed you mycophenolate for:
How to take mycophenolate
•Mycophenolate is usually taken twice a day, once in the morning and evening.
•Swallow the tablets whole with a glass of water.
•Mycophenolate is best taken after food.
•Handle the tablets as little as possible.
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Mycophenolate
Dose to take
•Your doctor will decide the best dose for you to take, depending on your
body weight.
•The dose will usually start off low for the first month to ensure that you do
not suffer any side effects.
•If you tolerate it well, the dose of mycophenolate may be increased by
your doctor.
•It may take up to six to 12 weeks before you see any benefit from
the treatment.
Date of dose change
Dose (mg) to be taken once a day
Side effects
If any of these symptoms develop, stop taking mycophenolate and see
your doctor immediately:
•redness of the skin or a skin rash, fever, shivering or chills
•feeling dizzy, confused, light-headed, weak or generally tired
•muscle and bone pain
•kidney problems such as changes in the amount of urine passed and
colour of the urine
•unexpected bleeding or bruising
•bad diarrhoea and/or abdominal pain
•fever or any other signs of infection
•developing jaundice (skin or white of the eyes turn yellow)
•blistering and/or peeling of the skin, lumps on the body or patches on
the skin
•loss of appetite, nausea and vomiting (reduced by taking tablets after food)
For a full list of all possible side effects that may occur when taking
mycophenolate, please read the leaflet supplied with your medicine.
Mycophenolate
3
Your immune system
Because mycophenolate suppresses your immune system, your body may not
be as effective at fighting off infection.
If you have any signs of infection (sore throat or fever), experience jaundice
(yellowing of the skin or whites of the eyes), or any unexplained bruising or
bleeding, tell your doctor immediately.
If you have not had chickenpox but come into contact with someone who
has chickenpox or shingles, you should see your doctor immediately as you
may need special treatment.
Patients receiving mycophenolate may be more likely to develop different
kinds of cancers, including skin cancers. Try to limit your time in the sun,
cover up with clothing and use high factor sun screen.
Mycophenolate may cause hair loss or thinning. Hair growth does usually
return to normal even if treatment continues but you should avoid hair dyes
or perms for the first few months as your hair will be weaker than normal.
Blood tests
Regular blood tests are important while taking mycophenolate, to check for any
unwanted effects on your liver and kidney function or blood cell production.
Your GP should arrange for you to have a blood test every week for the first
two months of therapy and then every two weeks until your target dose has
been reached. Your blood should then be tested monthly for the first year
and every second month thereafter.
Pregnancy and breastfeeding
Mycophenolate can cause problems for unborn babies so make sure that
you are not pregnant before starting to take mycophenolate. Due to this,
treatment will only start after a negative pregnancy test.
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Mycophenolate
Use adequate contraception before starting treatment, during treatment
and for eight weeks after stopping treatment. Please contact your doctor
immediately if you become pregnant while taking mycophenolate.
Similarly, do not breastfeed while you are taking mycophenolate as a small
amount of the drug can pass into breast milk.
Taking mycophenolate with other medicines
If you take any other medicines then please let your doctor know so that
they can check whether they are safe for you to take with mycophenolate.
If you are taking allopurinol or warfarin then your doctor would need to
give you a lower dose of mycophenolate and your warfarin dose would
need to be changed.
Buying medicines over-the-counter
Always let the pharmacist know that you are taking mycophenolate when
buying medicines. It is important that the pharmacist checks that the new
medicines will not interact with the mycophenolate and are safe for you to take.
It is also possible that the symptoms you are trying to treat with the medicine
may be a sign that the mycophenolate is not working safely for you. Keep a
record of any symptoms and discuss them with your doctor.
Vaccinations
Do not have any live vaccines while taking mycophenolate, and for a short
while afterwards. The fact that your body’s immune system is suppressed when
you are taking mycophenolate may mean that having the vaccine can cause an
infection and the response that you get to the vaccine may be reduced.
Discuss any vaccinations with your doctor as some vaccines are safe and
recommended, such as the pneumovax and flu vaccinations.
Mycophenolate
5
Forgetting to take your medicine
Never take two doses at once. If you forget to take mycophenolate, take it
as soon as you remember. If it is close to the time that your next dose is due,
however, miss the first dose and take the next one at the usual time.
If you are unsure what to do, please contact your doctor for advice.
If you take more tablets than you have been told to take, contact your
doctor immediately.
Storing your medicine
Keep your mycophenolate tablets out of the reach of children and at
room temperature.
Glossary
Hb: the oxygen carrying component of red blood cells
MCV: the average volume of a red blood cell
WBC: white blood cells
Platelets: an irregular, disc shaped element in the blood that helps in blood
clotting.
Lymphocytes: a small white blood cell that plays a large role in defending
the body against disease. They are responsible for immune responses.
Neutrophils: a type of white blood cell filled with enzymes used to kill and
digest micro-organisms.
ALT: an enzyme normally present in the liver and heart cells that is released
into the blood stream when the liver or heart is damaged. Abnormally high
ALT levels may indicate that the liver is not functioning normally.
ALK phos: an enzyme made in the liver which is usually released into the
blood during injury. Abnormally high levels may indicate some liver damage.
CRP: a component of the blood that rises in response to inflammation in the
body. This rate increases with more inflammation.
Urea and creatinine: substances normally cleared from the blood by the
kidneys. Increased blood levels of urea and creatinine indicate that kidneys
may not be functioning normally.
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Mycophenolate
Monitoring results
Please ask the person responsible for prescribing/monitoring your
treatment to record your test results below:
Date of blood test
Dose of mycophenolate
HB Male 130-170 g/L
Female 120-150 g/L
MCV 80-100fL
WBC 4-11 x 109/L
Platelets
150 -400 x 109/L
Neutrophils
2.0-7.5 x 109/L
Lymphocytes
1.5-4.0 x 109/L
ALT
10-40 IU/L
Alk phos
35-105 IU/L
CRP
0-7.5 mg/L
Urea
2.9-7.1 mmol/L
Creatinine
80-115 umol/L
Total Bilirubin
0-20 umol/L
Next test date
Mycophenolate
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Monitoring results
Please ask the person responsible for prescribing/monitoring your
treatment to record your test results below:
Date of blood test
Dose of mycophenolate
HB Male 130-170 g/L
Female 120-150 g/L
MCV 80-100fL
WBC 4-11 x 109/L
Platelets
150 -400 x 109/L
Neutrophils
2.0-7.5 x 109/L
Lymphocytes
1.5-4.0 x 109/L
ALT
10-40 IU/L
Alk phos
35-105 IU/L
CRP
0-7.5 mg/L
Urea
2.9-7.1 mmol/L
Creatinine
80-115 umol/L
Total Bilirubin
0-20 umol/L
Next test date
8
Mycophenolate
Monitoring results
Please ask the person responsible for prescribing/monitoring your
treatment to record your test results below:
Date of blood test
Dose of mycophenolate
HB Male 130-170 g/L
Female 120-150 g/L
MCV 80-100fL
WBC 4-11 x 109/L
Platelets
150 -400 x 109/L
Neutrophils
2.0-7.5 x 109/L
Lymphocytes
1.5-4.0 x 109/L
ALT
10-40 IU/L
Alk phos
35-105 IU/L
CRP
0-7.5 mg/L
Urea
2.9-7.1 mmol/L
Creatinine
80-115 umol/L
Total Bilirubin
0-20 umol/L
Next test date
Mycophenolate
9
Monitoring results
Please ask the person responsible for prescribing/monitoring your
treatment to record your test results below:
Date of blood test
Dose of mycophenolate
HB Male 130-170 g/L
Female 120-150 g/L
MCV 80-100fL
WBC 4-11 x 109/L
Platelets
150 -400 x 109/L
Neutrophils
2.0-7.5 x 109/L
Lymphocytes
1.5-4.0 x 109/L
ALT
10-40 IU/L
Alk phos
35-105 IU/L
CRP
0-7.5 mg/L
Urea
2.9-7.1 mmol/L
Creatinine
80-115 umol/L
Total Bilirubin
0-20 umol/L
Next test date
10
Mycophenolate
Monitoring results
Please ask the person responsible for prescribing/monitoring your
treatment to record your test results below:
Date of blood test
Dose of mycophenolate
HB Male 130-170 g/L
Female 120-150 g/L
MCV 80-100fL
WBC 4-11 x 109/L
Platelets
150 -400 x 109/L
Neutrophils
2.0-7.5 x 109/L
Lymphocytes
1.5-4.0 x 109/L
ALT
10-40 IU/L
Alk phos
35-105 IU/L
CRP
0-7.5 mg/L
Urea
2.9-7.1 mmol/L
Creatinine
80-115 umol/L
Total Bilirubin
0-20 umol/L
Next test date
Mycophenolate
11
Your details:
Name
Date of birth
Address
Contact telephone number
Contact details of the healthcare team looking after you:
Consultant
GP
Community pharmacy
For further information on medicines
Medicines information helpline
023 8120 6907 (9am to 6.30pm) [email protected]
For help outside of working hours call your out-of-hours GP or speak to the
on-call respiratory doctor via University Hospital Southampton switchboard
023 8077 7222.
If you need a translation of this document, an
interpreter or a version in large print, Braille
or audio, please call 023 8120 4688 for help.
www.uhs.nhs.uk
© 2014 University Hospital Southampton NHS Foundation Trust. All rights reserved.
Not to be reproduced in whole or in part without the permission of the copyright holder.
Version 2. Published July 2014. Due for review July 2017. MYCO001.02