Originator: Steph Mole Date: Sept 2011

Version: 1 Date for Review: Sept 2014DGOH Ref No: DGOH/PIL/00219

MYCOPHENOLATE MOFETIL /MMF / CELLCEPT RheumatologyPatient Information Leaflet

2 7

MYCOPHENOLATE MOFETIL / MMF /CELLCEPT Mycophenolate is in a family of drugs called Disease modifyinganti-rheumatic drugs DMARDS. Whilst your specialist will choosethe one he feels is best to treat you at the time based on researchand extensive knowledge of the drug you will always have thechoice to discuss other treatment options and alternative therapies.

What is Mycophenolate?Mycophenolate Mofetil is used in conditions where there is a needto dampen down over activity in the immune system such aspatients with kidney disease or multisystem diseases like SystemicLupus Erythematosus (SLE) and Vasculitis. Mycophenolate iscurrently only licenced for use in the UK in people who have had akidney transplant to prevent rejection of the new kidney. Howeverthere is increasing medical evidence that it is useful in controllingSLE and some forms of vasculitis, which have not responded toother drugs. It may be used in combination with your othermedications and is always given under the close supervision ofyour hospital doctor/nurse or in some cases your family doctor.Because mycophenolate is currently not licenced for use invasculitis and SLE your consultant will need to obtain specialpermission to use the drug and will issue your prescriptions on a1-3 monthly basis for collection from the hospital. Your consultantwill discuss these regulations and arrangements in more detail withyou.

Remember, whilst you are on this medication, it is yourresponsibility to ensure that you have regular blood tests and it isimportant that you do not miss any of these tests. If your hospitalappointment is rescheduled, contact the Rheumatology Helpline ifyou need more blood forms.

If you have any problems or questions, contact the RheumatologyHelpline on 01384 244789 or contact your pharmacist

Patient and Professional Organisations withUseful LinksArthritis Care - Tel: 0808 800 4050Arthritis Care: Welcome to Arthritis Carehttp://www.arthritiscare.org.uk

NHS Direct - Tel: 0845 4647http://www.nhsdirect.nhs.uk/

Dudley Group of Hospitals NHS Trust - Tel: 01384 456111(switchboard) The Rheumatology Department - Tel: 01384 244789 (Helpline)http://www.dgoh.nhs.uk/http://www.dgoh.nhs.uk/_public/_servportals/rheumatology/_public/_servportals/rheumatology/default.asp

6 3

How do I take Mycophenolate?Take this medication as directed usually twice daily ideally on anempty stomach one-hour before or two hours after meals. Swallowthis medication whole. Do not crush, chew or open it. Continuetaking this medication for the full time as prescribed. Do notincrease your dose or stop taking this drug without consulting yourdoctor/nurse.

How long will it take the Mycophenolate towork? Mycophenolate can take up six to eight weeks to work. There maybe further improvement up to six months after starting thetreatment.

Will I get any side effects?Like all medication side effects can occur. Mycophenolate will bestarted at a low dose and then increased to minimise the risk ofside effects. The most serious side effect is a decrease in thebody's ability to protect against infection. You should notify yourdoctor immediately if you develop signs of infection (such aspersistent sore throat or fever), weight loss, night sweats orenlarged lymph nodes/glands.

When should I NOT take the medication?This medication should not be used during pregnancy. It issuggested that contraceptive measures are taken before beginningtherapy and continuing for at least 6 weeks after this medication isdiscontinued. Discuss the risks and benefits with your doctor. It isnot known if this medication appears in breast milk. Consult yourdoctor/nurse before breast-feeding.

Can I have immunisations or vaccines whilston Mycophenolate?You should not have 'live' vaccines; these include vaccines forpolio and rubella (German measles). You can have annual 'fluvaccine and you may be advised to have a Pneumonia vaccine.

Other treatmentsYou always have the choice when taking any medicationprescribed in Rheumatology. There are "alternative treatments"that some people find useful and leaflets provided by ArthritisResearch Council are available in our clinics.

Over the counter medications may be used alone or in combinationwith prescribed medication you are taking however, you are alwaysadvised to discuss with your doctor who has prescribed beforetaking. Medication bought over the counter may help to control yourpain but not always the condition. Always tell the pharmacist ofyour prescribed medications when buying over the counter drugs.

Other possible side effectsThis medication may also cause dizziness, drowsiness, headache,nausea, vomiting, diarrhoea, flatulence, tremors, sweating,flushing, insomnia, muscle pain, rash, mood changes, or visionchanges, most of these side effects can be helped by reducing thedose of Mycophenolate for a short period of time. Rarer side effectsinclude unusual weakness, unusual or easy bruising, swollenglands, skin growths, chest pain (angina), swelling of the hands orfeet or difficulty breathing, contact your doctor or nurse immediatelyif you develop any of these symptoms.

How often do I need blood tests?As with other drugs you may have taken Mycophenolate Mofetilrequires you to be monitored closely.

Blood tests need to be done every week initially until the dose ofMycophenolate is stable for 4 weeks and then monthly thereafter.

It is your responsibility to have your blood tests. In order for us toreceive the results from your blood tests, you will have to have theblood test at any of the following centres:

Russell Hall Hospital: Monday to Friday 08.30am to 7.30 pm orSaturday 9.30am to 11.30am. No appointments required. Corbett Hospital: Monday to Friday 08.30am to 4.30 pm. Noappointments required.

Netherton Health Centre: Appointment required, ring 01384 366500

Cross Street Health Centre: Appointment required, ring 01384459500

Lady's Walk Clinic: Appointment required, ring 01902 575103

Are there any tablets I should avoid?Tell your doctor of any over-the-counter and all prescription drugsthat you are taking, including antacids, aspirin, theophylline,phenytoin, cholestyramine, probenecid, acyclovir or ganciclovir. Donot start or stop any medicine without doctor, nurse or pharmacistsapproval.

What do I do if I miss a missed dose?If you miss a dose take it as soon as you remember. If it is near thetime for the next dose, skip the missed dose and resume yourusual dosing schedule.

Do not "double-up" the dose to catch up. If you miss more than afew days of mycophenolate contact your health care professional toestablish a new dosing schedule.

4 5