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Mycophenolic acid-Myfortic and CellCept- Side Effects with Myasthenia Gravis
Mycophenolic acid, brand name Myfortic and CellCept, is an immunosuppressant delayed-release drug. Mycophenolic acid is most often used with other medicines to prevent organ rejection after an organ transplant. Mycophenolic acid is also now used to treat those above the age of 5 with Myasthenia gravis.
The medicine requires both males and females to use effective birth control measures to prevent pregnancy. The drug can cause a miscarriage or congenital disabilities when used during pregnancy.
Not only does mycophenolic acid increase your risk of cancer and infections, but it can lead to a never-ending list of side effects.
I experience many side effects on this list. Still, the list is so broad that my doctor doesn’t necessarily believe the symptoms I am experiencing are from mycophenolic acid. However, the timing lines up perfectly for me when I started taking the medication. My MG symptoms are under control, and prednisone is the only other prescription I’m on.
Call your doctor right away if you have any alarming symptoms. Most common side effects include upset stomach, nausea, vomiting; diarrhea, constipation; low blood cell counts, infections; sleep problems; painful urination.
Do you experience any continuing symptoms taking mycophenolic acid for Myasthenia gravis?
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10 Replies
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I take 2000 mg of Mycophenolate Mofetil daily. Presumably we are talking about the same thing. I have been taking the same amount for approximately 18 months. My other Mg medications are Mestinon and Soliris(infusion). The only side effect I experience of the above is occasional diarrhea which I more attribute to the Mestinon than the Cellcept. My neurologist at my last visit said we would discuss cutting back the Cellcept at my nest appointment.
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THANK YOU, Jodi, for your comments about Mycophenolate. I am in my 9th month of use at 1500 mg/day. I have had no adverse reactions to it, but always appreciate warnings and follow-up info. The point about increased cancer risk is certainly worth investigating. My neurologist really wants to avoid steroid use for me, so this is his choice. I’d love more info/stats on the cancer risks. I’ll look into that some more.
I am also taking Pyridostigmine (480mg/day) & have IVIG every 3 weeks. This regimen has brought me from a very low place to maybe 75-80% former strength.
Strange disease, eh? I really appreciate this forum and all your work and input.
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I’m on 2000 mg mycophenolate mofetil (cellcept) per day for the second year. I was diagnosed with generalized MG a month after my eyelid drooped, and was on steroids and mestinon the first year, then weaned off steroids and switched to cellcept because mestinon was making my eyes twitch so hard I could barely drive. My neurologist says the cancer risk is rare and most cases occur after decades of taking this medication, and my family doctor does a very thorough annual cancer screening. My symptoms have been under control since I was diagnosed, and the most troublesome side effect I have from cellcept is due to immune suppression. I’ve had one infection after another. 8 months of sinus infections and antibiotics, a bladder infection, carbuncles (boils), a return of acne, fungal infections in skin folds, etc. I have to shower and dry thoroughly daily with antibacterial soap and use anti-fungal ointment or spray in certain spots. I’m really sensitive to overheating but less so with my hair up and if I walk long distances or climb stairs, I have to be careful I don’t trip due to not lifting my feet as high but that rarely happens. Overall, I live a pretty normal life. I’ve also noticed that I get restless legs at night more often and more intensely. My family is prone to restless leg syndrome but taking magnesium usually controls it, except magnesium is not recommended for people with MG so I can’t take it anymore. I have insomnia more often, too, and sometimes I only get 1 hour of sleep. That’s apparently a side effect of cellcept but I’m on other medications at very low doses for other conditions that also affect sleep. I had my annual review with my neurologist today and asked if I could reduce the dose of cellcept since I’ve been so stable, and he said to ask him again in a year because it’s recommended that there be several years symptom-free before reducing the cellcept dose, and I’m almost there. I’ve found that most health care professionals have heard of myasthenia gravis – it was my optometrist who recommended I see my family doctor when my eyelid drooped because it could be MG. Then my family doctor, who has an autoimmune disease, too, did some basic tests for MG and referred me to a rapid assessment neurology clinic where they did a series of tests, including the one with electric currents that revealed all of my muscles are affected. My neurologist is associated with this clinic at a research university and the interns at the clinic are always wowed that they’re meeting someone with MG because they’re taught that it is quite rare. I realize I’m very fortunate that it was diagnosed so quickly and accurately and that I’ve stabilized long term.
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Cellcept seriously elevated my liver enzymes and lipids. I stopped use and am now on Imuran. So far, labs on this med are OK. No matter which immunosuppressive treatment you’re on, make sure your labs are checked regularly. My docs have it done every 3-4 months.
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Excellent point about liver enzymes which is one of the reasons I was switched from mestinon to cellcept. I had monthly blood tests until Covid hit. My doctors weighed the risk of catching Covid at a busy lab against a year of normal blood tests & decided I could forego the tests temporarily. Had a test recently- still normal.
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Just to make sure I was clear: Cellcept is what caused very high liver enzymes and lipids in me… not mestinon.
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Your post was clear – my post agreed on the importance of regular blood tests to monitor the liver. I probably shouldn’t have mentioned that testing was also done in my case with Mestinon & continued once I was switched to Cellcept. Monitoring in my case confirmed that Cellcept is being tolerated.
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I am not sure if what I experience is caused by the prednisone or Cellcept? I have been on prednisone since April (down to 20 mg daily) and starting in June Cellcept 500mg daily. The plan was to increase Cellcept to 500mg twice daily but I developed a stubborn Thrush infection so he said to hold off a while pending blood tests. (white blood count & glucose elevated)
I also wake up during the night and have trouble going back to sleep, I bruise and bleed very easily, my face especially around my eyes feels swollen and puffy, I have gained weight, and it seems I am developing slight tremors in my hands. It is hard to know if my fatigue is due to sleeplessness or MG? All in all I count myself lucky that this is all that I have going on.
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I’m on 2000 mg Cellcept per day and I’ve noticed facial puffiness, constant skin and other infections, tremors in my hands/arms while exercising, fatigue and a marked change in sleep pattern. I used to have trouble getting to sleep, now I am so tired that I fall asleep right away but wake up fully alert usually 2 or 3 hours later when its too late to take a sleeping pill. I can’t get back to sleep until 5 or 6 am. Frustrating because I follow all of the sleep hygiene and relaxation recommendations. The acne is frustrating too as 30 yrs ago, I had 3 rounds of Accutane (oral Vitamin A derivative) to resolve adult-onset acne, and have had beautiful skin since. That’s gone now. When I went off Cellcept for 2 weeks for each of the last 2 Covid shots, I felt great and had tons of energy. My neurologist said after 3 years of stability, I could trial being taken off Cellcept to see if I am in remission. 3 yrs is in 2 months – I can’t wait!
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Hi, FYI
Please note: Mycophenolic acid (Myfortic) is <b>not the same as mycophenolate mofetil (CellCept)</b> and is absorbed by your body differently. These two medications are dosed differently and are not interchangeable.
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