Phenocept 500mg Tablet

✔️ Uses of Phenocept 500mg Tablet

• Prevent organ transplant rejection

✔️ How does Phenocept 500mg Tablet work?

Phenocept 500mg Tablet works by suppressing the immune system so that the body does not reject the transplanted organ. 

✔️ Side Effects of Phenocept 500mg Tablet

The main adverse effects linked to Mycophenolate Mofetil include diarrhea, reduced white blood cell count, sepsis, gastrointestinal candidiasis, urinary tract infection, herpes simplex infection, and vomiting. Moreover, there's an indication of an increased occurrence of specific infections, especially opportunistic ones.

✔️ Quick Suggestions:

• Maintain a well-balanced and nutritious diet to aid in your swift recovery.
• Collaborate with a dietitian to formulate a diet plan tailored to your specific health needs.
• Refrain from consuming raw or insufficiently cooked food to prevent potential risks.
• Guard yourself against sunlight and soil exposure. Utilize protective clothing like long-sleeved garments, hats, long pants, and footwear when outdoors. Additionally, apply high-SPF sunscreen.
• Steer clear of individuals who are unwell to avoid potential infections. Limit alcohol intake and cease smoking for better overall health.
• If you intend to travel, particularly to developing nations, engage in a discussion with your doctor at least two months in advance.
• Your doctor may recommend regular blood tests to monitor your blood cell counts and liver functionality.
• Typically, these tests are scheduled every 2 to 4 weeks within the initial two months, followed by intervals of 2 to 3 months. Do not undergo immunizations or vaccinations without obtaining your doctor's approval.
• Exercise caution around individuals who have recently received live vaccines, such as nasal-spray flu vaccines.

✔️ Indication of Phenocept 500mg Tablet

Mycophenolate Mofetil, combined with corticosteroids and either ciclosporin or tacrolimus, is used for:

• Preventing acute organ rejection and treating initial or resistant organ rejection in patients who have undergone allogeneic renal transplants.
• Preventing acute organ rejection in patients with allogeneic cardiac transplants.
• Preventing acute organ rejection in patients with allogeneic hepatic transplants.
• Treating patients with Class III-V lupus nephritis (diagnosed based on the International Society of Nephrology/Renal Pathology Society classification) by providing induction and maintenance therapy.

✔️ Pharmacology

Mycophenolate mofetil is derived from mycophenolic acid (MPA) through the 2-morpholino ethyl ester. MPA acts as a potent, selective, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). This action leads to the inhibition of the de novo pathway for the synthesis of guanosine nucleotides. The mechanism by which MPA hinders IMPDH's enzymatic activity involves structural resemblance to both the cofactor nicotinamide adenine dinucleotide and a catalytic water molecule. This structural mimicry prevents the oxidation of inosine monophosphate (IMP) to xanthosine-5'-monophosphate, a crucial step in the biosynthesis of guanosine nucleotides.

MPA has a particularly strong impact on lymphocytes, more so than other cell types. T- and B-lymphocytes heavily rely on the de novo synthesis of purines for their proliferation, whereas other cell types can utilize salvage pathways. Mycophenolic acid, the metabolically active form of mycophenolate mofetil, acts as a non-competitive, reversible inhibitor of IMPDH. This inhibition effectively halts the de novo synthesis of guanosine nucleotides, which are crucial building blocks for DNA and RNA synthesis. While other cell types can use alternative pathways, B and T lymphocytes depend on the de novo pathway for the generation of guanosine.

In vitro, studies demonstrate that mycophenolic acid and/or mycophenolate mofetil can suppress mixed lymphocyte responses and the proliferation of human peripheral blood lymphocytes in response to various stimulants like mitogens and antigens. Mycophenolic acid also reduces the intracellular levels of guanosine triphosphate (GTP) and deoxyguanosine triphosphate (dGTP) in human peripheral blood monocytes or T lymphocytic cell lines activated by mitogens. Notably, mycophenolic acid does not influence GTP concentrations in human neutrophils.

✔️ Dosage & Administration of Phenocept 500mg Tablet

Adult Dosage:

• Prophylaxis of acute renal graft rejection (using Mycophenolate Mofetil - MMF): Take 1 g twice daily, starting within 72 hours of transplantation. The maximum dosage is 2 g per day.
• Prophylaxis of cardiac graft rejection, Liver Transplant: Take Mycophenolate Mofetil (MMF) at a dose of 1.5 g twice daily, starting within 5 days after transplantation.

Child Dosage:

• Children below 3 months: Safety and efficacy not established.
• Children above 3 months: For prophylaxis of organ rejection in patients receiving allogeneic renal transplants, use Mycophenolate Mofetil (MMF) as follows:
  • MMF (suspension): 600 mg/m² orally every 12 hours, not exceeding 2 g/day
  • MMF capsules/tablets: Depending on body surface area (BSA)
    • BSA 1.25-1.5 m²: Take a 750 mg capsule every 12 hours
    • BSA >1.5 m²: Take a 1 g capsule/tablet every 12 hours

Renal Impairment:

• MMF in severe renal impairment (GFR <25 mL/min/1.73 m²): Do not exceed 1 g every 12 hours.
• No dosage adjustment is needed in renal transplant patients with delayed graft function post-operatively.

Administration:

• Take the drug on an empty stomach, 1 hour before or 2 hours after meals.
• Once the dosage is stable, MMF can be taken with food after a kidney transplant.
• Take Phenocept 500mg Tablet as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the tablet.
• Your dosage will depend on the type of transplant received. Do not stop the medicine suddenly without consulting your doctor.

✔️ Interaction

When taking Phenocept 500mg Tablet, it's important to carefully consider the concomitant use of the following medicines:

1. Other immune-suppressing medicines like azathioprine and tacrolimus.
2. Antiviral medicines such as aciclovir and ganciclovir.
3. Medicines to lower cholesterol levels, like cholestyramine.
4. Antibiotics, particularly rifampicin which is commonly used in tuberculosis treatment.
5. Medicines for acidity issues, including antacids and drugs like pantoprazole and rabeprazole.
6. Antifungal medicines like isavuconazole.
7. Live vaccines might not work effectively due to the immune-suppressing nature of Phenocept 500mg Tablet.
8. Medicines for high blood pressure, such as telmisartan.

✔️ Contraindications

Do not take Phenocept 500mg Tablet if:

• You have a known allergy to mycophenolate or any other component of this medicine.
• You are pregnant or planning to conceive.
• There is any chance that you may be pregnant.
• You are not using an effective contraception method.
• You breastfeed your baby.

✔️ Pregnancy & Lactation

Mycophenolate Mofetil is contraindicated in pregnancy and during breastfeeding. The safe use of Mycophenolate Mofetil during labor and delivery has not been established.

✔️ Precautions & Warnings

Mycophenolate mofetil poses a risk of causing birth defects in animals, therefore, prevent inhalation or direct contact with the skin. Patients should be observed for lymphoproliferative disorders, and they should be advised to restrict exposure to sunlight and UV light. Regular complete blood cell counts (CBCs) should be performed to monitor for neutropenia. It's important to note that mycophenolate mofetil and mycophenolate sodium are not interchangeable.

For lactating individuals, it is uncertain whether the drug is excreted in breast milk, hence it is advised to avoid using it or not to nurse while on treatment.

✔️ Storage Conditions

Store at a temperature below 30º C in a cool and dry place. Keep it out of the reach of children and pets.