What are the aims of this leaflet?
This leaflet has been written to help you understand more about mycophenolate mofetil. It will tell you what it is, how it works, how it is used to treat skin conditions, and where you can find out more about it.
What is mycophenolate mofetil and how does it work?
- Mycophenolate mofetil (MMF) belongs to a group of medications known as immunosuppressive agents which work by suppressing the body’s own defence system (the immune system).
- It is mainly used in patients who receive organ transplants (eg. kidney, liver or heart) to stop the body from rejecting a transplanted organ.
- MMF can also be used to treat a wide range of skin conditions either by itself or in combination with other drugs.
Which skin conditions are treated with mycophenolate mofetil?
- MMF is used to treat a number of inflammatory skin conditions.
- These include severe atopic dermatitis (eczema), blistering conditions, lupus erythematosus, dermatomyositis, sarcoidosis, necrobiosis lipoidica, cutaneous vasculitis, morphoea and pyoderma gangrenosum.
When should I take mycophenolate mofetil?
- Mycophenolate mofetil is usually taken twice daily: in the morning and the evening.
- The tablets should be swallowed whole and should not be broken or crushed.
What dose of mycophenolate mofetil should I take?
- Mycophenolate mofetil is available in 250mg capsules and 500mg tablets or capsules.
- The normal dose is between 1 and 3 g daily.
- You should only take the dose advised by your dermatologist.
How long will I have to take mycophenolate mofetil for?
- The length of treatment will depend on how well you respond to treatment.
- You may need to take mycophenolate mofetil for several months before you notice any change in your condition.
- If you find it effective, mycophenolate mofetil can be continued long term.
What are the possible side effects of mycophenolate mofetil?
Mycophenolate mofetil is generally well tolerated with fewer side effects compared to other immune suppressing medications.
Occasionally it can cause some side effects including the following:
- Gastrointestinal – nausea, vomiting, diarrhoea, constipation and abdominal pain. These are usually mild and do not require you to stop taking the medication.
- Infection – MMF can increase your risk of infections. You should seek urgent medical attention if you become unwell with a fever while taking MMF.
- Anaemia – MMF can cause anaemia however your doctor will regularly check your blood results to monitor this.
- Skin cancer – taking MMF long term can increase your risk of skin cancer. You should avoid excessive exposure to sunlight by not sunbathing, wearing suitable clothing (e.g. long sleeves and sunhat) and using sunscreens with a sun protection factor (SPF) of at least 30 and a star rating of at least 4. Please visit www.bad.org.uk for further advice on skin care and the sun.
- Lymphoma – taking MMF for a number of years is associated with a very small increased risk of certain types of cancer affecting the lymph nodes. If you detect any new swellings or lumps, or changes in your skin, which last more than two weeks you should inform your doctor immediately.
How will I be monitored for the side effects of mycophenolate mofetil treatment?
- Your doctor will arrange for you to have regular blood tests to monitor your blood count, kidney and liver function whilst you are taking mycophenolate mofetil.
Blood tests will need to be done frequently (e.g. weekly) whilst starting MMF however once you established on treatment they are needed less often (every 1- 3 months).
Does mycophenolate mofetil affect pregnancy?
- Females must not become pregnant whilst on mycophenolate mofetil as there is a risk of harm to the unborn child.
- A pregnancy test may be performed before starting treatment.
- If you are planning to become pregnant or in the event of a pregnancy, you should contact your doctor immediately.
- Females should use two forms of effective contraception prior to commencing treatment, during treatment and for six weeks after stopping treatment.
- Mothers who are taking MMF should not breastfeed.
- Men (including those who have had a vasectomy) taking MMF and their female partners should use effective contraception during treatment and for 90 days (or 13 weeks) after stopping treatment.
Can I take other medicines at the same time as mycophenolate mofetil?
- Mycophenolate mofetil can interfere with some medications and this may alter the dosage of mycophenolate mofetil that you may require.
- Before starting treatment with MMF your doctor will ask you to list all medicines that you are taking (whether on prescription or bought over the counter).
- Do not begin any new medicine or change the dose of your existing medications without first checking with your doctor or pharmacist.
Medications that can cause problems when taking mycophenolate mofetil include:
- Antiepileptic drugs
- Antiviral drugs such as aciclovir and valaclovir
- Antibiotics such as co-amoxiclav, metronidazole, norfloxacin and rifampicin
Can I have immunisation injections while on mycophenolate mofetil?
- You should avoid immunisation injections with any of the live vaccines including MMR (measles, mumps, rubella), chickenpox, polio, shingles, yellow fever and the nasal flu vaccine.
- If you require immunisation with a live vaccine then this should be discussed with your doctors as mycophenolate mofetil will need to be stopped for a period before and after the vaccination.
- Yearly ‘flu’ influenza, all Covid-19 vaccines available at the time of writing in 2021, and 5 yearly pneumococcal vaccine are safe and recommended.
- The new nasal flu vaccination is live and should not be given with MMF (see Patient Information Leaflet on Immunisations).
- Inactivated vaccines are safe but may be less effective in protecting you if you continue to take mycophenolate mofetil.
Can I drink alcohol whilst taking mycophenolate mofetil?
- Alcohol can safely be consumed whilst taking MMF however it is advisable to keep alcohol consumption within recommended guidelines.
- The national guidelines for safe consumption advise that men and women should not drink more than 14 units a week.
- Further guidelines available at: http://www.nhs.uk/Livewell/alcohol/Pages/alcohol-units.aspx
Where can I find out more about mycophenolate mofetil?
- If you want to know more about mycophenolate mofetil, or if you are worried about your treatment, you should speak to your doctor, nurse or pharmacist.
- This information sheet does not list all of the side effects of mycophenolate mofetil.
- For more detail and information, look at the drug information sheet which comes as an insert with your prescription for mycophenolate mofetil.
Please note that the BAD provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.
This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.
This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel
BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET
PRODUCED AUGUST 2004
UPDATED MAY 2010, AUGUST 2013, SEPTEMBER 2017, SEPTEMBER 2021
NEXT REVIEW DATE SEPTEMBER 2024