In August 2000, the Food and Drug Administration (FDA) approved the use of mycophenolate mofetil in patients undergoing liver transplants, and the drug is used primarily to ease the acceptance of a transplanted organ by a recipient. The drug makes acceptance of the transplanted organ more likely because it prevents the recipient from mounting an immune response to the organ, or treating it like a foreign invader. The drug also seems to have the ability to inhibit tumor growth, and may prove effective in treating certain kinds of cancer.
In laboratory studies, mycophenolate mofetil has inhibited tumor growth in cancers of the pancreas, colon, lung, and blood. The value of the drug for anticancer therapy is still being evaluated.
Mycophenolate mofetil suppresses, or prevents activity of, cells in the lymphatic system, both T cells and B cells. Under normal circumstances, T cells mount an immune response by reacting directly with foreign materials in the body and B cells release compounds that attack foreign materials. But during a transplant, T cells and B cells can cause a reaction that leads to the rejection of a donor organ.
The drug is given orally and by intravenous line. Dosages given for cancer therapy are experimental. To prevent immune response during organ transplants, the drug is dispensed in capsules of 250 mg, tablets of 500 mg, and by intravenous line in doses of 500 mg. Time intervals between dosages are determined according to how the drug is broken down once in a patient.
In addition to increasing the risk of lymphomas and skin cancer, mycophenolate mofetil may cause a number of other unwanted reactions. They include dizziness, headache, trembling, as well as pain in the chest, swelling (edema), and high blood pressure (hypertension). Many digestive tract upsets from constipation to diarrhea to vomiting are also possible side effects. There is also a chance of hemorrhage, or uncontrolled bleeding in the digestive tract.
Taking the drug is likely to make oral contraceptives ineffective and another form of birth control should be used. Stomach medications that contain magnesium and aluminum hydroxides, such as antacids, can block the uptake of mycophenolate mofetil across the gut. They should be avoided. As always, the physician in charge of the care plan should be told of every drug a patient is taking so that the potential for interactions can be avoided. The drug is considered superior to some others used as a
Diane M. Calabrese
—A tube that is inserted directly into a vein to carry medicine directly to the blood stream, bypassing the stomach and other digestive organs that might alter the medicine.
—Metric measure that equals 2.2 pounds.
—The system that collects and returns fluid in tissues to the blood vessels and produces defensive agents for fighting infection and invasion by foreign bodies.
—One-thousandth of a gram, and there are one thousand grams in a kilogram. A gram is the metric measure that equals about 0.035 ounces.
—Altered, not normal.
—A cell in the lymphatic system that contributes to immunity by attacking foreign bodies, such as bacteria and viruses, directly.