In some pediatric rheumatic diseases, part of the immune system is over-activated. Mycophenolate mofetil inhibits the proliferation of B and T lymphocytes (these are specific white blood cells); in other words, it decreases the rate of development of some of the immune active cells. This effect starts after some weeks.
The drug can be given as tablets or powder for solution from 1 to 3 g per day. It is recommended that mycophenolate mofetil is consumed between meals, as food intake may decrease the absorption of this substance. If a dose is missed, the patient should not take a double dose the following time. The product should be stored in the original packaging, tightly closed. Ideally, drug concentrations should be determined by analyzing several blood samples taken the same day at different times; this allows proper adjustment of the dosage in an individual patient.
The most common side effect is gastrointestinal discomfort, seen in 10-30% of cases, especially at the beginning of treatment. There may be diarrhea, nausea, vomiting or constipation. If these side effects persist, a reduced dose may be taken or a shift to a similar product (myfortic) can be considered. The drug might lead to a decrease in white blood cells and/or platelets; hence, these should be monitored monthly. Administration of the drug should be temporarily withdrawn in the event of a decrease in white blood cells and/or platelets.
The drug can cause an increased risk of infections. Drugs that suppress the immune system can result in an abnormal response to live vaccines. It is therefore recommended that your child should not receive live vaccines such as the measles vaccine. Consult with a physician before vaccinations and before traveling abroad. Pregnancy should be avoided during mycophenolate mofetil therapy.
Routine clinical examinations (monthly) and blood and urine testing are necessary to detect and respond to possible side effects.
Juvenile Systemic Lupus Erythematosus.