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Lupus Medications – CellCept (mycophenolate mofetil)

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Updated December 14, 2007

What is CellCept?:

CellCept (mycophenolate mofetil, or MMF) is an immunosuppressant often used in patients with lupus nephritis (in which the disease attacks the kidneys). Immunosuppresives are used in the treatment of lupus because:

  • They are potent drugs and help control disease activity in major organs, and,
  • May reduce or eliminate the need for steroids.
It is available only by prescription.

It should be noted that MMF has been shown to significantly reduce steroid dosage for patients with lupus nephritis or treatment-resistant systemic lupus erythematosus, and is considered a first-line therapy for lupus nephritis, often replacing cyclophosphamide.

How does it work?:

As an immunosuppressive, it works by weakening the body's immune system so it will not produce auto-antibodies. The immune system of lupus patients produces auto-antibodies at a rapid rate, which in turn attack the immune system. When this happens, victims can suffer inflammation (the primary feature of lupus), pain, and tissue damage.

Who shouldn’t take, or should check with their doctor before taking CellCept?:

  • Pregnant and nursing mothers
  • Those planning to have children (both women and men)
    • Note: On Oct. 29, 2007, Roche, which manufactures CellCept, and the FDA notified healthcare providers that use of MMF is associated with increased risk of first trimester pregnancy loss and increased risk of congenital malformations, especially external ear and facial abnormalities including cleft lip and palate, and anomalies of the distal limbs, heart, esophagus, and kidney. The pregnancy category for MMF has been changed from Category C (risk of fetal harm cannot be ruled out) to Category D (positive evidence of fetal risk).
  • Those taking acetazolamide, acyclovir, antibiotics; azathioprine, chlorothiazide, cimetidine, cholestyramine, colestipol, ethacrynic acid, furosemide, ganciclovir, isoproterenol, meperidine, morphine, oral contraceptives, phenytoin, probenecid, procainamide, quinine, salicylate pain relievers, choline magnesium trisalicylate, choline salicylate, diflunisal, magnesium salicylate and salsalate, and theophylline.
  • Those who suffer from liver or kidney disease
  • Those who suffer from Lsech-Nyhan or Keeley-Seegmiller Syndrome

When should you take CellCept?:

Though dosage varies by patient, most take the drug once a day. Your doctor will determine your regimen.

What are possible side effects?:

  • Constipation
  • Diarrhea
  • Stomach pain
  • Upset stomach
  • Vomiting
  • Difficulty falling asleep or staying asleep
  • Pain in the back, muscles or joints

More Serious Side Effects:

As always, contact your doctor immediately if you develop any of the following symptoms.

  • Swelling of the hands, feet, ankles, or lower legs
  • Difficulty breathing
  • Uncontrollable shaking hands
  • Unusual bruising or bleeding
  • Headache
  • Fast heartbeat
  • Fatigue
  • Dizziness
  • Pale skin
  • Weakness
  • Black and tarry stools
  • Red blood in stools
  • Bloody vomit
  • Vomiting material that looks like coffee grounds
  • Loose, floppy muscles
  • White patches in mouth or throat
  • Swelling of gums
  • Vision changes
  • Rash

Is there a generic version?:

Mycophenolate mofetil, but there is presently no less expensive generic brand on the market.

Does it go by any other brand names?

No.

Sources:
Lupus Foundation of America statement on Results for Clinical Study of CellCept released by Aspreva Pharmaceutical Company. Lupus Foundation of America. June 27, 2007.

MedlinePlus Drug Info. MedlinePlus.com. Revised Nov. 1, 2007.

Chat Transcript - Dr. Joan Merrill. Lupus Foundation of America, Dec. 6, 2006

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