Alternate Name(s):
CellCept®, MMF
Classification:
Immunosuppressant agent -NON-CYTOTOXIC HAZARDOUS
Original Date:
August 2005
Revised Date:
June 2015
Indications:
- For the prophylaxis of organ rejection in patients receiving renal transplants and in patients receiving allogenic cardiac or hepatic transplants
Reconstitution and Stability:
- Available as 500 mg lyophilized powder vial
- Vials are stored at room temperature
- Reconstitute each vial using 14 mL of D5W to make a 33.3 mg/mL solution; gently shake to mix
- Reconstituted solution will be slightly yellow
- Further dilute with D5W to a concentration of 6 mg/mL
- Stable 7 days at room temperature when diluted to 1 - 10 mg/mL
- Store diluted infusion solution and reconstituted vials at room temperature
- Prepare drug in biohazard hood. Handle and dispose of biohazard waste as per hospital policy
Compatibility:
- Solutions Compatible: D5W only
INCOMPATIBLE with all other IV solutions
DO NOT administer other IV drugs concurrently via the same infusion line
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
NO |
| IV Intermittent Infusion |
YES |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- GVHD:
- 10-40 mg/kg/day IV divided Q12H
- Renal Transplant:
- 600-1200 mg/m2/day PO divided Q12H; MAX of 3 g/day
- Convert PO to IV at a ratio of 1:1
- Patients should be switched to the oral route as soon as they can tolerate oral medication
- IV can be administered for up to 14 days
Potential hazards of parenteral administration:
- Phlebitis and thrombosis via peripheral route
- Diarrhea, vomiting
- Leukopenia, sepsis
- Numerous adverse effects have been reported in clinical trials; those effects reported in >20% of patients include: body aches, abdominal pain, fever, anemia, urinary tract infections, hypertension, peripheral edema, constipation, nausea. Refer to product monograph in CPS for complete listing.
- Anaphylaxis has been reported (rarely)-contraindicated in patients allergic to polysorbate 80 (TWEEN) or mycophenolate mofetil/mycophenolic acid
- GI bleed and severe neutropenia have been reported (rarely)
Notes:
- Monitoring parameters: CBC with differential, platelets, serum electrolytes, glucose, phosphate, cholesterol, renal function tests, blood pressure
- Because of risk of teratogenicity, caution should be exercised in handling and preparation. Avoid skin contact of the solution. If contact occurs, wash thoroughly with soap and water. Rinse eyes with plain water.
- Should be administered within 24 hours following transplantation
- May be used concomitantly with cyclosporine and corticosteroids