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Mycophenolate is a medication that comes with important safety considerations. It is crucial to be aware of these potential risks and precautions in order to use this drug safely and effectively. Please review the following information and consult your healthcare provider if you have any questions or concerns:

• Increased Infection Risk: Mycophenolate can weaken your immune system, making you more susceptible to serious infections, including bacterial, fungal, and viral, such as polyomavirus-associated nephropathy (PVAN), progressive multifocal leukoencephalopathy (PML), and COVID-19. Notify your healthcare provider immediately if you experience symptoms like fever, chills, persistent sore throat, body aches, painful or urgent urination, or a persistent cough.

• Cancer Risk: This medication may increase the likelihood of developing cancers such as lymphomas and skin cancer. Protect your skin from sun exposure by using sunscreen and wearing protective clothing. Report any unusual symptoms, such as swollen glands, sudden weight loss, night sweats, changes in moles, or other unusual skin changes, to your healthcare provider.

• Pregnancy Warning: Mycophenolate can harm an unborn baby, potentially leading to miscarriage or birth defects. It is imperative that individuals who are pregnant or may become pregnant use reliable birth control. A pregnancy test is required before starting treatment and periodically during treatment. Discuss any concerns with your healthcare provider.

• Blood Cell Count Monitoring: The drug can cause a reduction in red and white blood cells and platelets, increasing the risk of bleeding, anemia, and infections. Regular blood tests may be required to monitor your blood cell levels.

• Stomach Bleeding and Ulcers: Mycophenolate may lead to serious gastrointestinal issues, such as bleeding and ulcers. Seek immediate medical attention if you experience symptoms like faintness, vomiting blood, blood in stools, or severe and persistent stomach pain. The risk is higher in older adults and those with a history of stomach issues or taking alcohol or medications that increase bleeding risk.

• Genetic Conditions: Individuals with hypoxanthine-guanine phosphoribosyltransferase (HGPRT) deficiency or phenylketonuria (PKU) should avoid mycophenolate. For PKU, especially if using the oral suspension form, inform your provider for an alternative formulation.

• Potential for Inflammation: Rare cases of inflammation have been reported. Symptoms include fever, joint or muscle pain, and abnormal lab results. Contact your healthcare provider if you notice these symptoms.

• Impact on Driving and Operating Machinery: Mycophenolate can cause sleepiness, dizziness, low blood pressure, confusion, and tremors, affecting your ability to drive or operate machinery safely. Discuss with your provider if these side effects occur.

• Contraindications: Do not use mycophenolate if you have a known allergy to the medication or its components, such as mycophenolic acid.

Remember, this information is a summary of potential risks and precautions associated with mycophenolate. Always consult your healthcare provider for comprehensive guidance tailored to your individual health needs.

Common side effects:

• constipation
• nausea
• headache
• diarrhea
• vomiting
• stomach upset
• gas
• tremors
• dizziness
• drowsiness

• trouble sleeping

  Less common but important to monitor:

• muscle, neck, or back pain
• high blood pressure
• swelling
• fever
• weakness
• high blood sugar
• high cholesterol
• shortness of breath
• stomach pain
• cough
• viral infections
• indigestion
• depression
• tremors
• fast heart rate
• low platelet count

• low blood magnesium or potassium levels

  Serious side effects:

• unusual tiredness
• fast or irregular heartbeat
• easy bleeding or bruising
• swelling of the feet or ankles
• joint pain or stiffness
• muscle pain
• persistent stomach or abdominal pain
• black stools
• vomit resembling coffee grounds
• chest pain
• rapid breathing
• progressive multifocal leukoencephalopathy (PML)
• rash
• itching
• swelling (particularly of the face, tongue, or throat)
• severe dizziness
• trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Natalizumab
• Rituximab

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Hormonal birth control (pills, patch, or ring)
• Amoxicillin
• Cholestyramine
• Ciprofloxacin
• Clavulanic Acid
• Colesevelam
• Colestipol
• Desogestrel
• Dexlansoprazole
• Dienogest
• Drospirenone
• Esomeprazole
• Estradiol
• Ethinyl Estradiol
• Ethynodiol
• Gestodene
• Isavuconazonium Sulfate
• Lansoprazole
• Levonorgestrel
• Mestranol
• Metronidazole
• Nomegestrol
• Norethindrone
• Norfloxacin
• Norgestimate
• Norgestrel
• Omeprazole
• Pantoprazole
• Rabeprazole
• Rifampin
• Telmisartan
• Tofacitinib

Interactions with low risk that usually do not require a change in therapy:

• Cyclosporine
• Lanthanum Carbonate
• Sevelamer