CellCept (mycophenolate mofetil) is used to help a patient prevent rejection of a transplanted organ, predominantly a heart, liver, or kidney, though it may be used in other cases. It is nearly always used along with cyclosporine and corticosteroids, and sometimes other medications as well.

Off-label this medication may be used to help treat conditions associated with an overactive immune system, such as lupus.

CellCept has been used in patients as young as 3 months in kidney transplants. There is little data concerning use in children for other organs. Doctor instructions should be followed carefully if prescribed for any patient under age 18. Off-label use in children is not advised.

What to Expect from CellCept

CellCept is an antimetabolite immunosuppressant, which should be used with other immunosuppressant medications to prevent organ rejection. Put simply, all immunosuppressants inhibit immune system response, which prevents the immune system from targeting the new organ as a foreign object and working to reject it.

Organ transplants are complicated, and patients will undoubtedly spend some time in the hospital following the surgery. Treatment with CellCept will begin in the hospital, likely administered by IV for the first few days or weeks. Most patients are switched to tablets, capsules, or oral solutions as soon as able to take them, and this use will continue at home.

Duration of CellCept use is variable, depending on a number of other factors, such as other medications also being taken and patient response to treatment. Assuming no serious adverse effects develop, treatment can continue for as long as it provides benefit, usually at least one year and sometimes considerably longer.

As CellCept inhibits the immune system, patients taking it (or any immunosuppressant) are at increased risk of getting a serious infection. Patients should be alert for symptoms and take care to avoid scenarios where infection is likely.

Patients taking CellCept are also at increased risk of getting certain types of cancer, particularly skin cancer. Again patients should be alert for symptoms.

CellCept can cause birth defects or even a miscarriage if taken during conception or while pregnant. This applies to men as well as women with regard to conception. Both genders should avoid conception for 90 days after treatment with CellCept ends. Women who are pregnant should avoid this medication entirely. If that's not possible, discuss options with a doctor.

Note that birth control pills may be made less effective by CellCept; alternative methods of birth control are strongly recommended.

Taking CellCept

As mentioned above, CellCept comes in several formulas:

• Intravenous solution
• Injectable solution
• Capsules (250 mg each)
• Tablets (500 mg each)
• Oral Suspension (200 mg/mL)

Intravenous and injectable solutions are reserved for hospital use. The other three may be used at home. Oral suspension may be drank or administered via gastric feeding tube, if needed. A pharmacist typically prepares the oral solution, though some patients acquire it as a powder and mix it with fluid themselves.

Dosage can be quite variable, depending on a number of factors, particularly for children. A doctor will determine dosage and patients are strongly encouraged to follow doctor instructions.

General treatment guidelines for adults:

• For heart or liver transplants, most patients take 1.5 g twice per day, for a total daily dose of 3 g.
• For kidney transplants, most patients take 1 g twice per day, for a total daily dose of 2 g.
• Some kidney transplant patients are given 1.5 g twice per day, for a total daily dose of 3 g, though studies suggest those taking 2 g per day had equal benefit with fewer serious adverse reactions.

Patients can take multiple tablets or capsules to get the correct dose; for example, a patient taking 1.5 g per dose should take three 500 mg capsules or six 250 mg tablets.

Again, other medical conditions, other medications, patient response, and so forth can all influence dosage and duration of treatment. Doctor instructions may deviate considerably from the above.

Potential Complications

Most of the severe adverse effects were covered above, which are:

• Birth defects or miscarriage
• Serious infection risk
• Increased risk of some types of cancer

For infections and cancer risk, a doctor should go over symptoms and warning signs. If any are experienced---or any disruptive side effect---do not be afraid to consult a doctor or seek medical attention.

Other serious side effects include:

• Low white blood cell counts
• Gastrointestinal bleeding
• Gastrointestinal perforation

Though not quite as common as the upper list, the latter, if experienced, can become serious enough that treatment with CellCept may need to end. Other immunosuppressants, with a different active ingredient, may be tried instead.

Regular checkups will be scheduled for any transplant patient, and should be kept. A doctor can screen for any developing side effects and make necessary adjustments if found, as well as ensure the medication is continuing to work as intended.

Patients taking CellCept should not donate blood or semen for at least 90 days after treatment ends.