| CELLCEPT |
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Mycophenolate Mofetil/Cellcept – Roche Labs.What is it? Cellcept is a powerful immunosuppressant created initially for use in preventing the rejection of organ transplants. It works by blocking the action of a compound within the body which is required for producing T and B lymphocytes – the immune cells responsible for regulating and triggering immune responses. Who is it for? Moderate to severe plaque psoriasis sufferers who are non-responsive to other lines of treatment. It is also used by dermatologists for the treatment of other skin conditions. How is it taken and how much do I take? MMF is available in 250mg capsules and 500mg tablets. The amount taken is derived partly by weight and partly by response. The average dose can lie anywhere between 1 and 3mg daily and is split into two doses – one AM and one PM and should be taken with water only. As with all strong drugs, care should be taken by the patient to make sure they are taking the correct amount. Tablets should not be crushed and capsules not opened. If the powdered form comes into contact with the skin, eyes or mucus membranes wash immediately. What are the side effects and the contra-indications? Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Headache Depression Blood disorders Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain Seizures (convulsions) Increased susceptibility to infections Cold or flu-like symptoms Dizziness Alteration in taste Loss of appetite Decrease in the number of white blood cells in the blood (leucopenia) Excessive fluid retention in the body tissues, resulting in swelling (oedema) Difficulty in breathing (dyspnoea) Weakness or loss of strength (asthenia) Disturbances in the levels of chemical components (electrolytes) in the blood A general feeling of being unwell (malaise) Ulceration or bleeding of the stomach or intestines Increased risk of developing lymphomas and other cancers, particularly skin cancer As with all medicines, other drugs can interact and either affect the absorption or increase the toxicity of Cellcept. These include: Antacids, such as aluminium hydroxide and gaviscon reduce absorption. Antiepileptic drugs such as phenytoin are less well absorbed. The tranquilliser clozapine increases the risk of a fall in white blood cell count and lowers defence against infection. Cellcept interacts with some antiviral drugs including aciclovir and ganciclovir. Lipid-regulating drugs (e.g. cholestyramine) can affect absorption. It is therefore vital you tell both the prescribing doctor and the pharmacist that you are taking Cellcept. Pregnancy and breastfeeding are contra-indicated. Good contraception is vital when taking it and for up to six months after ceasing Cellcept. Cellcept makes the skin photosensitive and extreme care should be taken in the sun. Further, there is evidence that it increases the risk of skin cancers and over exposure should be avoided. Live vaccines should be avoided whilst taking Cellcept and can lower their efficiency. What monitoring do I need? It is vital that a patient is monitored by a doctor whilst taking Cellcept. This will show up any abnormalities long before they become a problem. Blood monitoring should be followed weekly for the first month, bi-weekly for the second month and third month and then monthly for the first year of treatment - these will include tests for liver and kidney function as well as full blood counts. Discuss this and many other topics in the forums. SJ May 2005
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