Mycophenolate

Mycophenolate is an immunosuppressive agent used to prevent your body from rejecting a kidney, liver, or hear transplant. Mycophenolate is usually given with cyclosporine (Sandimmune, Neoral) and a steroid medication.

Mycophenolate is available under the following different brand names: CellCept, Myfortic, and MMF.

Dosage Forms and Strengths

Capsule

• 250 mg

Tablet

• 500 mg

Oral suspension

• 200 mg/mL

Powder for injection (adult only)

• 500 mg/mL

Tablet, delayed release

• 180 mg
• 360 mg

Dosage Considerations – Should be Given as Follows:

Kidney Transplant

Prophylaxis of organ rejection in patients receiving allogeneic renal transplants; use concomitantly with cyclosporine and corticosteroids

Adults:

• Mycophenolate mofetil (MMF): 1 g orally/intravenously every 12 hours, infused over 2 hours or more
• Mycophenolic acid (MPA): 720 mg orally every 12 hours

Pediatric:

Children under 3 months

• Safety and efficacy not established

Children over 3 monthsChildren over 3 months

• Prophylaxis of organ rejection in patients receiving allogeneic renal transplants
• MMF (suspension): 600 mg/m² orally every 12 hours; not to exceed 2 g/day
• MMF: BSA 1.25-1.5 m²: 750 mg capsule orally every 12 hours
• MMF: BSA greater than 1.5 m²: 1 g capsule/tablet orally every 12 hours
• Extended-release MPA: 400 mg/m² orally every 12 hours; not to exceed 720 mg every 12 hours

Heart Transplant

• Prophylaxis of organ rejection in patients receiving allogeneic cardiac transplants; use concomitantly with cyclosporine and corticosteroids
• MMF: 1.5 g oral/intravenous every 12 hours, infused over 2 hours or more

Liver Transplant

• Prophylaxis of organ rejection in patients receiving allogeneic hepatic transplants; use concomitantly with cyclosporine and corticosteroids
• MMF intravenous (IV): 1 g every 12 hours; infused over 2 hours or more
• MMF (oral): 1.5 g every 12 hours

Dosing Considerations

Renal Impairment

• MMF: In severe renal impairment (glomerular filtration rate [GFR] less than 25 mL/minute/1.73 m²), not to exceed 1 g every 12 hours
• No dosage adjustment needed in renal transplant patients experiencing delayed graft function postoperatively

Lupus Nephritis (Off-label)

• Induction therapy for lupus nephritis (MMF)
• Induction: 1 g orally every 12 hours with a glucocorticoid or 2-3 g for 6 months with glucocorticoids
• Maintenance: 0.5-3 g/day or 1 g orally every 12 hours or 1-2 g daily
• Administer with initial intravenous (IV) corticosteroid pulse for 3 days, then prednisone 0.5-1 mg/kg/day orally; not to exceed 10 mg/day; after a few weeks, prednisone may be tapered to lowest effective dose