From the Guidelines
Cellcept, also known as mycophenolate mofetil, is an immunosuppressant medication that should be used with caution due to its potential to cause birth defects and other serious side effects, as evidenced by a study published in 2023 1.
Key Points
- The typical oral dose for adults is 500 to 2000 mg per day, as stated in a study published in 2019 1.
- Cellcept works by inhibiting an enzyme crucial for the growth of T and B lymphocytes, thereby suppressing the immune response that leads to organ rejection.
- Common side effects include gastrointestinal disturbances, increased risk of infections, and potential for anemia or leukopenia, as reported in a study published in 2020 1.
- Regular blood tests are necessary to monitor blood cell counts and kidney function.
- Patients should be advised to avoid pregnancy while taking Cellcept due to the risk of birth defects, with a study published in 2023 1 reporting miscarriage rates of 49%, stillbirth rates of 2%, and structural anomaly rates of 23%.
- It's essential to take Cellcept consistently and not to stop abruptly without consulting a healthcare provider, as this could lead to organ rejection.
Important Considerations
- Cellcept is contraindicated in pregnancy, and patients should use two reliable forms of contraception, as stated in a study published in 2023 1.
- A washout period of 12 weeks from the last MMF dose is recommended before attempting pregnancy, as reported in a study published in 2023 1.
- The use of Cellcept in combination with other immunosuppressive agents, such as cyclosporine and tacrolimus, should be carefully monitored to minimize the risk of adverse effects, as discussed in a study published in 2016 1.
From the FDA Drug Label
Mycophenolate mofetil is a prescription medicine to prevent rejection (antirejection medicine) in people who have received a kidney, heart or liver transplant. Mycophenolate mofetil has been demonstrated in experimental animal models to prolong the survival of allogeneic transplants (kidney, heart, liver, intestine, limb, small bowel, pancreatic islets, and bone marrow). Mycophenolate mofetil is the 2-morpholinoethyl ester of mycophenolic acid (MPA), an immunosuppressive agent; inosine monophosphate dehydrogenase (IMPDH) inhibitor.
Cellcept (Mycophenolate mofetil) is an immunosuppressive agent used to prevent rejection in people who have received a kidney, heart, or liver transplant. It works by inhibiting the body's immune system and preventing it from attacking the new organ. 2, 2, 2
From the Research
Definition and Mechanism of Action
- Cellcept, also known as Mycophenolate mofetil (MMF), is a prodrug of mycophenolic acid (MPA), an inhibitor of inosine monophosphate dehydrogenase (IMPDH) 3
- IMPDH is a key enzyme in the de novo purine synthesis of lymphocytes, and its inhibition leads to selective lymphocyte suppression 4, 5, 6
- MPA has a more potent cytostatic effect on lymphocytes than on other cell types, making it an effective immunosuppressive agent 3
Clinical Use and Efficacy
- Cellcept is used to prevent or treat allograft rejection after solid-organ transplantation 5, 6
- The drug has been shown to be effective in preventing acute renal allograft rejection, and its efficacy has been established in several clinical trials 3, 4, 6
- Cellcept is also used in combination with other immunosuppressive drugs, such as cyclosporin and corticosteroids, to prevent rejection in transplant patients 4, 6
Pharmacokinetics and Adverse Effects
- Cellcept is rapidly and completely absorbed following oral administration, with a maximum plasma concentration occurring after two hours 5
- The most common adverse effects of Cellcept are gastrointestinal, and the drug may also be linked to bone marrow suppression and certain malignancies 5, 6
- However, one study reported a case of a patient who ingested 10 grams of mycophenolate mofetil without experiencing any adverse effects 7