CELLCEPT 500MG TABLETS 50`S

CellCept (mycophenolate mofetil) is an immunosuppressant medicine that prevents the body's immune system from rejecting a transplanted organ. When a person receives a donor kidney, heart, or liver, the immune system recognises the new organ as 'foreign' and attacks it — this is called rejection. CellCept suppresses this immune response by blocking the proliferation of the lymphocytes (white blood cells) that drive the attack.

CellCept is always used in combination with cyclosporine and corticosteroids and is prescribed and monitored exclusively by specialist transplant physicians.

Approved Indications

•     Prevention of acute rejection in kidney (renal) transplant recipients — in combination with ciclosporin and corticosteroids

•     Prevention of acute rejection in heart (cardiac) transplant recipients — in combination with ciclosporin and corticosteroids

•     Prevention of acute rejection in liver (hepatic) transplant recipients — in combination with ciclosporin and corticosteroids

•     Also used off-label: lupus nephritis, vasculitis, IgA nephropathy, inflammatory myopathies, and other autoimmune conditions

Kidney Transplant — Adults

•     1 g (2 × 500 mg tablets) twice daily. Start within 72 hours of transplant. Total daily dose: 2 g

Heart Transplant — Adults

•     1.5 g (3 × 500 mg tablets) twice daily. Start within 5 days of transplant. Total daily dose: 3 g

Liver Transplant — Adults

•     1.5 g (3 × 500 mg tablets) twice daily. Total daily dose: 3 g

Children (1–18 years)

•     Based on body surface area (BSA): typically 600 mg/m² twice daily. Your transplant team will calculate the specific dose.

Administration

•     Best taken on an empty stomach — 1 hour before or 2 hours after meals — for maximum absorption

•     If GI side effects are problematic, may be taken with food (minor reduction in absorption)

•     Swallow tablets whole. DO NOT crush or chew — mycophenolate powder is teratogenic and must not contact skin or mucous membranes

Missed Dose

Take as soon as you remember. If it is almost time for the next dose, skip it — never double up. Contact your transplant team if unsure.

Common (may affect more than 1 in 10 patients)

•     Diarrhoea, nausea, vomiting, abdominal pain — gastrointestinal side effects are the most common

•     Infections: viral (CMV), bacterial, and fungal — common due to immune suppression

•     Anaemia, neutropenia (low white cells), thrombocytopenia (low platelets)

•     Headache, hypertension, tremor, insomnia, peripheral oedema

Serious — Tell Your Transplant Team Immediately

•     Serious, life-threatening infections: bacterial sepsis, CMV disease, pneumonia, PML (progressive multifocal leukoencephalopathy — a rare brain infection caused by the JC virus)

•     Malignancies: increased risk of lymphoma and skin cancers with long-term immunosuppression

•     Pure red cell aplasia (PRCA): rare but serious blood disorder requiring dose reduction

•     Neutropenia: may require dose reduction or treatment interruption

•     Known hypersensitivity to mycophenolate mofetil, mycophenolic acid, or any ingredient

•     Pregnancy — ABSOLUTELY CONTRAINDICATED: causes miscarriage and serious birth defects

•     Females of reproductive age NOT using two reliable methods of contraception simultaneously

•     Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome (rare enzyme disorders)

Pregnancy — CRITICAL TERATOGEN

CellCept causes miscarriage and serious birth defects (external ear, facial, heart, kidney, and limb malformations). Females MUST use TWO reliable methods of contraception starting 4 weeks before, throughout treatment, and for 6 weeks after stopping. Two negative pregnancy tests are required before starting in women of reproductive potential.

Breastfeeding

Not recommended — it is unknown whether mycophenolate passes into breast milk.

Infection Risk

CellCept suppresses the immune system — avoid contact with people who have active infections. Report any fever, cough, or unusual symptoms to your transplant team immediately.

Sun Protection

Long-term immunosuppression significantly increases skin cancer risk. Use SPF 50+ sunscreen, protective clothing, and avoid excessive sun exposure throughout therapy.

•     Antacids (aluminium/magnesium — e.g. Maalox): Reduce MMF absorption — separate by at least 2 hours

•     Proton pump inhibitors (omeprazole, pantoprazole): May reduce MMF absorption — clinical significance varies; consider monitoring

•     Ciclosporin: Reduces MMF levels by inhibiting enterohepatic circulation — monitor transplant efficacy

•     Tacrolimus: When switching from ciclosporin, MMF levels may rise — monitor for toxicity

•     Aciclovir, ganciclovir: Compete with MMF for renal tubular secretion — monitor both drugs' levels

•     Cholestyramine: Reduces MMF levels significantly — avoid concurrent use

•     Live vaccines: CONTRAINDICATED during immunosuppressive therapy

•     Azathioprine: Avoid concurrent use — no added benefit and significantly increased toxicity

•     Store at 15–30°C, away from moisture, heat, and light

•     Keep in original packaging

•     Handle with care: do not crush or break tablets without protective gloves

POM — Prescription Only Medicine. Specialist transplant physician prescription required. Pharmacy dispensing should verify pregnancy prevention plan in women of reproductive age at every dispensing.

•     Take every dose at the same times each day — consistency is critical for transplant protection

•     Tell all other healthcare providers (including dentists) that you take CellCept

•     Apply sunscreen (SPF 50+) every day — long-term use significantly increases skin cancer risk

•     Attend all monitoring blood tests as scheduled by your transplant team

•     Teratogenicity programme: At every dispensing for women of reproductive age — verify two methods of contraception are in use and document. Pregnancy prevention programme compliance is mandatory.

•     MPA exposure monitoring: Trough levels of MPA can guide dosing (target AUC 30–60 mg·h/L in renal transplant), though not always measured routinely

•     GI side effects: Most common reason for dose reduction — splitting dose to 3× daily (total dose unchanged) can improve GI tolerability; Myfortic (EC-MPS) may be switched if persistent

•     Ciclosporin interaction: MMF levels are ~30–50% lower when co-prescribed with ciclosporin vs tacrolimus — patients switching between calcineurin inhibitors need MMF dose reassessment

•     CMV prophylaxis: High-risk transplant patients on MMF require co-prescription of valganciclovir for CMV prophylaxis — MMF increases CMV susceptibility

•     Handling: Wear gloves when handling broken or crushed tablets; powder is teratogenic — protect pharmacy staff

Q: Can I ever stop taking CellCept?

A: You should never stop or reduce CellCept without first consulting your transplant specialist. Stopping suddenly can cause your immune system to attack and reject your transplanted organ — which can be life-threatening. Most transplant patients take CellCept or a similar drug for the rest of their lives.

Q: Is it safe to have vaccinations while on CellCept?

A: Live vaccines (such as BCG, yellow fever, MMR, varicella) are contraindicated because the weakened live virus in the vaccine could cause a real infection in your suppressed immune system. Inactivated vaccines (influenza, hepatitis B, pneumococcal) may be given but may not work as effectively. Always discuss any planned vaccination with your transplant team first.

Q: Why can't I take antacids at the same time as CellCept?

A: Antacids containing aluminium or magnesium bind to CellCept in the stomach and significantly reduce how much enters your bloodstream — meaning your transplanted organ may not be adequately protected. Always separate antacids from CellCept by at least 2 hours.