Mycophenolate mofetil

Complete blood count (CBC), liver function tests, renal function tests, hepatitis B and C screening, HIV serology.

Cellcept®: 2 × 250–500 mg/day initially, 2 × 500–1,500 mg/day maintenance dose;

Myfortic®: 2 × 180–360 mg/day initially, 2 × 360–720 mg/day maintenance dose.

2-4 months.

Months 1–3: complete blood count (CBC) every 1–2 weeks; renal and liver function tests once a month. From month 4 onwards: complete blood count (CBC) once a month.

Bone marrow disorders (cytopenias), chronic hepatitis B (HBsAg-positive); pregnancy and breastfeeding; women of childbearing potential not using contraception.

Creatinine clearance < 25 mL/min; maximum 2 g/day of CellCept® or 1.44 g/day of Myfortic®. Avoid live vaccines. Annual influenza and pneumococcal vaccinations are recommended. In patients with HIV infection, individual risk assessment is required. Antacids and cholestyramine reduce enteral absorption; aciclovir and probenecid reduce renal excretion.

Gastrointestinal symptoms ➝ Reduce the dose or divide into 4–6 single doses per day; infections ➝ Suspend treatment, possibly discontinue. Neutropenia < 1.3 x 10⁹/ l (= 1.3 G/ l) ➝ Temporary suspension. Thrombocytopenia < 80–100 x 10⁹/l (= 80–100 G/l)
➝ Interruption, possibly discontinuation. Consult specialists in the event of other side effects. Increased risk of lymphomas and other malignancies, particularly of the skin. Do not donate blood. Men: do not donate sperm during and for up to 90 days after treatment.

Unlimited.