From the Guidelines
CellCept (mycophenolate mofetil) can cause diarrhea in patients, and managing this side effect is crucial to prevent dehydration and ensure the medication's efficacy in preventing organ transplant rejection or treating autoimmune disorders. According to the study published in the American Journal of Transplantation 1, frequent side effects of MMF include gastrointestinal issues, such as diarrhea. To manage mild diarrhea, patients can try taking CellCept with food, dividing their daily dose into smaller, more frequent doses, staying hydrated, and temporarily avoiding spicy or high-fiber foods.
Some key considerations for managing CellCept-induced diarrhea include:
- Monitoring blood work, such as CBC counts, every 1 to 3 months while on therapy 1
- Checking mycophenolate blood levels if signs and symptoms of GI intolerance, like diarrhea, develop 1
- Avoiding live vaccines and concomitant use of azathioprine while being treated with mycophenolate 1
- Contacting the healthcare provider immediately if severe diarrhea, bloody stools, fever, or signs of dehydration occur
It's essential to note that the diarrhea occurs because CellCept inhibits lymphocyte proliferation but also affects rapidly dividing cells in the intestinal lining. If the diarrhea becomes intolerable or dangerous, the doctor might adjust the dosage, switch to an extended-release formulation, or consider alternative immunosuppressants.
From the FDA Drug Label
The most common adverse reactions in clinical trials (20 % or greater) include diarrhea, leukopenia, infection, vomiting, and there is evidence of a higher frequency of certain types of infections e.g., opportunistic infection. (6. 1) Stomach problems including intestinal bleeding, a tear in your intestinal wall (perforation) or stomach ulcers can happen in people who take mycophenolate mofetil for injection. Bleeding can be severe and you may have to be hospitalized for treatment. Call your doctor right away if you have sudden or severe stomach-area pain or stomach-area pain that does not go away, or if you have diarrhea. Side effects that can happen more often in children than in adults taking mycophenolate mofetil for injection include: ... diarrhea
Diarrhea is a common side effect of Mycophenolate, it can occur in up to 20% of patients taking the medication 2. Patients taking Mycophenolate should be monitored for stomach problems, including diarrhea, and should contact their doctor right away if they experience sudden or severe stomach-area pain, or if they have diarrhea 2.
- Key points:
From the Research
Cellcept Diarrhea
- Cellcept, also known as mycophenolate mofetil (MMF), is a potent immunosuppressor that can cause intestinal disorders, including diarrhea 3, 4.
- Diarrhea is a common side effect of MMF treatment, and its physiopathology remains unclear 3.
- The mechanism of MMF-induced diarrhea is unknown, but some theories have been postulated, including the possibility that it may be due to lower levels of the enzyme inosine monophosphate dehydrogenase (IMPDH) 4.
- Studies have shown that MMF-induced diarrhea can be dose-dependent and may appear commonly during the first 2 months of treatment 3.
- Histopathologic examination of patients with MMF-induced diarrhea has shown villous atrophy, and symptoms have improved with discontinuation of MMF and addition of folic acid 4.
- Diarrhea is a common complication in immunocompromised patients, including those taking MMF, and can be caused by a range of infectious and noninfectious factors 5.
Management of Cellcept Diarrhea
- Treatment of MMF-induced diarrhea may involve discontinuation of MMF, addition of folic acid, and/or use of antimotility agents such as loperamide 4, 6.
- In some cases, MMF-induced diarrhea may be managed with a reduction in dose or temporary withdrawal of the medication 3, 4.
- The use of adjunctive loperamide in combination with antibiotics has been shown to be effective in reducing the duration and severity of diarrhea in some cases 6.