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Cellcept

Chemical name is mycophenolate mofetil (MMF) by Roche

If you take Cellcept, please read this warning!

Approved for heart transplant patients in February of 1998, Cellcept is rapidly absorbed, then changed by your body into MPA (mycophenolic acid). MPA is a powerful immunosuppressant that inhibits both T-cells and B-cells. Cellcept is used as one part of combination therapy to prevent organ rejection, usually with cyclosporine or tacrolimus.
     Cellcept is preferred over azathioprine (Imuran by Burroughs Wellcome). Used with steroids and cyclosporine in a heart transplant trial, Cellcept reduced acute rejection and death better than azathioprine. Gastro-intestinal side effects and risk of infection were greater with Cellcept, but atherosclerosis may be reduced with it more than with azathioprine.
     Patients who develop gout while taking Cellcept can take allopurinol - a drug that cannot be used when taking azathioprine. Cellcept costs more than azathioprine.

Cellcept Dose

Cellcept comes in tablet form, capsule of liquid form, and also as a powder that is mixed with Dextrose to make an IV drug. The tablets are 500mg and the capsules are 250mg. The liquid form contains 200mg/mL and has a shelf life of 60 days after mixing, which is done by the pharmacist. One vial of the fruit flavored oral liquid is equal to a 500mg tablet in strength. Storing the liquid in a refrigerator is okay.
     The IV form contains 6mg/mL and must be used within 4 hours after mixing. Cellcept should be taken before meals, on an empty stomach. Your actual dose will vary but 3 grams per day is a common starting dose for heart transplant patients.
     Blood tests will be done to measure your blood level of Cellcept once a week for the first month, once every 2 weeks for the second and third months, then once a month for the rest of the first year.

Possible Side Effects

You will not get all, or even most, of these side effects, but they are possible. The principal side effects seen with Cellcept use include diarrhea, leukopenia (reduced number of white blood cells), sepsis, nausea and vomiting. There is also a higher frequency of certain infections. This is not a complete list.
     These side effects were reported in clinical trials on heart transplant recipients only. The patients took 3 grams Cellcept per day. A trial done with kidney transplant recipients used only 2 grams per day and a considerably lower number of patients reported side effects. So if your dose can be held lower than 3 grams per day, side effects may be less.

Side Effects - Cancers

Side Effects - Infections
Drug Interactions With Cellcept

Drug interactions are no joke for heart transplant recipients. You must never take any drug or over-the-counter medicine without checking first with your transplant cardiologist. Period. If you are allergic to Polysorbate 80, you should not take Cellcept. Cellcept has been tested in combination with the anti-rejection drugs cyclosporine (Sandimmune, Neoral), prednisone, antithymocite globulin (Atgam), and OKT3 (Orthoclone). This is not a complete list.

Mothers, Children, and Other Notes 

Adverse effects (mainly head and eye defects) on unborn baby rats and rabbits have been seen when the mother took Cellcept. This happened at doses lower than those which would be used in a heart transplant animal. Therefore the drug may harm an unborn child if given to a pregnant woman. Fertile women should test negative for pregnancy before starting Cellcept.
     Effective contraception must be used before beginning Cellcept, while taking it, and for 6 weeks after stopping the drug, unless the woman has had a hysterectomy. Two reliable forms of birth control must be used at the same time if sex is possible. Nursing mothers should not breast feed their infant(s). See this page for more about pregnancy after heart transplant.
     Cellcept's safety has not been established in children. Cellcept capsules and tablets are manufactured in Puerto Rico. Cellcept for intravenous use is manufactured in the USA.


Material taken from manuals given to potential transplant recipients at transplant centers in the USA, online drug monographs, the manufacturer, published medical trials from Medline, The Cleveland Clinic newsletter (winter of 1998), and medical dictionaries - Updated April 24, 2002

All information on this site is opinion only. All concepts, explanations, trials, and studies have been re-written in plain English and may contain errors. I am not a doctor. Use the reference information at the end of each article to search MedLine for more complete and accurate information. All original copyrights apply. No information on this page should be used by any person to affect their medical, legal, educational, social, or psychological treatment in any way. I am not a doctor. This web site and all its pages, graphics, and content copyright © 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004 Jon C.

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