Mycophenolate Mofetil (CellCept) and Mycophenolate Sodium (Myfortic): What You Need to Know
Mycophenolate Mofetil (MMF) and Mycophenolate Sodium (MPS) are two forms of the same drug, Mycophenolic Acid (MPA), which is used to treat various autoimmune diseases. MPA works by inhibiting the growth of certain types of white blood cells that are involved in inflammation and tissue damage. MPA can help reduce the symptoms and prevent the complications of diseases such as systemic lupus erythematosus (SLE), systemic sclerosis (SSc), inflammatory myopathies, and some systemic vasculitides.
How are MMF and MPS different?
MMF and MPS are not interchangeable, nor dose equivalents. MMF is a prodrug that is rapidly converted to MPA in the body. MPS is an enteric-coated tablet that releases MPA in the small intestine. MPS may cause less gastrointestinal side effects, such as diarrhea, indigestion, and abdominal pain, than MMF. However, both drugs have similar efficacy and safety profiles in treating autoimmune diseases.
The usual dose of MMF is 1000 mg twice a day, while the usual dose of MPS is 720 mg twice a day. Both drugs should be taken on an empty stomach to increase absorption, or with meals at consistent times each day to improve tolerability. The dose may vary depending on your weight, kidney function, blood tests, and response to treatment. Your doctor will monitor your condition and adjust your dose accordingly.
What are the benefits of taking MMF or MPS?
MMF and MPS can help control the inflammation and prevent the organ damage caused by autoimmune diseases. They can also reduce the need for other immunosuppressive drugs, such as corticosteroids, which have more side effects in the long term. Studies have shown that MMF and MPS can improve the survival and quality of life of patients with SLE, SSc, inflammatory myopathies, and some systemic vasculitides.
What are the possible side effects of taking MMF or MPS?
As with any medication, MMF and MPS may cause some side effects. The most common ones are:
- Gastrointestinal: nausea, vomiting, diarrhea, indigestion, abdominal pain, ulcers, bleeding
- Infections: urinary tract infections, respiratory infections, herpes zoster, cytomegalovirus
- Blood: anemia, leukopenia, thrombocytopenia
- Liver: elevated liver enzymes
- Skin: rash, itching
- Nervous system: headache, dizziness
Some of these side effects may be mild and transient, while others may be serious and require medical attention. You should report any new or worsening symptoms to your doctor as soon as possible.
MMF and MPS can also increase your risk of developing certain types of cancers, especially skin cancer and lymphoma. You should avoid excessive sun exposure and use sunscreen and protective clothing when outdoors. You should also have regular skin checks by a dermatologist. You should report any unusual lumps or growths to your doctor as soon as possible.
What precautions should I take while taking MMF or MPS?
Before starting MMF or MPS, you should tell your doctor if you have any allergies, infections, liver or kidney problems, stomach ulcers or bleeding disorders. You should also tell your doctor if you are pregnant or planning to become pregnant, or if you are breastfeeding or planning to breastfeed.
MMF and MPS can harm an unborn baby or cause birth defects. You should not take MMF or MPS if you are pregnant or planning to become pregnant. You should use effective contraception while taking MMF or MPS and for at least six weeks after stopping the medication. You should also avoid becoming pregnant while your partner is taking MMF or MPS and for at least 90 days after he stops the medication.
MMF and MPS can pass into breast milk and harm a nursing baby. You should not breastfeed while taking MMF or MPS and for at least six weeks after stopping the medication.
You should not receive any live vaccines while taking MMF or MPS and for at least six weeks after stopping the medication. Live vaccines include measles, mumps, rubella (MMR), varicella (chickenpox), yellow fever, and oral polio. You should also avoid contact with people who have recently received these vaccines or have active infections.
You should not take any other medications, supplements, or herbal products without consulting your doctor first. Some of these products may interact with MMF or MPS and affect their effectiveness or safety. Some of the products that may interact with MMF or MPS include:
- Antacids, cholestyramine, colestipol, iron, magnesium, calcium, and aluminum: These products may reduce the absorption of MMF or MPS and decrease their blood levels.
- Acyclovir, ganciclovir, valacyclovir, valganciclovir: These antiviral drugs may increase the risk of blood disorders when taken with MMF or MPS.
- Probenecid, rifampin: These drugs may increase the elimination of MMF or MPS and decrease their blood levels.
- Warfarin: MMF or MPS may increase the effect of warfarin and increase the risk of bleeding.
- Vaccines: MMF or MPS may reduce the immune response to vaccines and increase the risk of infections.
You should have regular blood tests to monitor your kidney function, liver function, blood counts, and drug levels while taking MMF or MPS. You should also have regular urine tests to check for infections. Your doctor will adjust your dose based on these tests and your clinical condition.
How much does MMF or MPS cost?
The cost of MMF or MPS may vary depending on your insurance coverage, pharmacy, and dosage. The following table shows the average price of MMF and MPS in different countries, based on online sources as of September 2023. The prices are in US dollars and do not include shipping fees or taxes.
| Country | MMF 1000 mg (per tablet) | MPS 720 mg (per tablet) | Reference |
|---|---|---|---|
| USA | $6.50 | $7.00 | GoodRx |
| Canada | $1.50 | $1.70 | Canada Drugs Direct |
| UK | $0.80 | $0.90 | Pharmacy2U |
| Australia | $0.60 | $0.70 | Chemist Warehouse |
| India | $0.30 | $0.40 | Medindia |
| Note: The prices are for reference only and may change over time. | |||
What are the top five global brands of MMF or MPS?
The following list shows the top five global brands of MMF or MPS, based on their market share as of 2021 [5]. The list is in descending order of popularity.
- CellCept (Roche): The original brand of MMF that was approved by the FDA in 1995 for the prevention of organ rejection in kidney transplant recipients. It is also approved for heart and liver transplant recipients, as well as for various autoimmune diseases.
- Myfortic (Novartis): The first enteric-coated brand of MPS that was approved by the FDA in 2004 for the prevention of organ rejection in kidney transplant recipients. It is also approved for various autoimmune diseases.
- Mycophenolate Accord (Accord Healthcare): A generic brand of MMF that was approved by the FDA in 2015 for the prevention of organ rejection in kidney transplant recipients. It is also used for various autoimmune diseases.
- Mycophenolate Sandoz (Sandoz): A