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Nurs 115 Chapter 13 Prototype Medication Card Notes
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Prototype Medication Drug CardName of Medication: Mycophenolate mofetil IV
Generic/Trade (Brand)- CellCept
Category/Classification: Cytotoxic immunosuppressive Agents
Routes/Dosage: renal transplantation: PO, IV 1g twice daily. Cardiac and hepatic
transplantation:
PO, IV 1.5g twice daily. Extended-release tablets (Myfortic) PO 720 mg twice daily.
Uses/Indications:
Use in Children
Children 3 months of age and older undergoing renal transplantation have taken
mycophenolate. Those who experience postoperative delayed graft function do not require
dosage adjustments. Children with impaired renal function taking mycophenolate warrant
close observation for adverse effects.
Use in Older Adults
Mycophenolate has similar therapeutic and adverse effects in older adults compared with
younger adults. However, because older adults often have multiple disorders and decreased
organ function, it is especially important that drug choices, dosages, and monitoring tests be
individualized.
Use in Patients With Renal Impairment
Mycophenolate produces higher plasma levels in renal transplant recipients with severe renal
impairment than in patients with less severe renal impairment (and in healthy volunteers). It
is important to avoid doses higher than 1 g twice a day in these patients.
Use in Patients With Hepatic Impairment
Liver impairment may interfere with metabolism, increasing drug half-life.
Use in Patients Receiving Home Care
With patients who are taking mycophenolate and other immunosuppressant drugs, a major
role of the home care nurse is to assess the environment for potential sources of infection,
assist patients and other members of the household to understand the patient’s susceptibility
to infection, and teach ways to decrease risks of infection.
Contraindications: Use of cytotoxic immunosuppressant drugs is not recommended during
pregnancy or lactation. The FDA has issued a Black box warning for mycophenolate mofetil
regarding the risk of fetal loss and malformations. Women of childbearing age must use
contraception. A negative pregnancy test for such women is required prior to starting therapy.
Contraceptive counseling for patients of both sexes is recommended prior to treatment and for
several months after stopping treatment.
Adverse reactions/Side effects: Common GI adverse effects of mycophenolate include nausea,
vomiting, and diarrhea. The most serious risks associated with the use of this drug and some
other immunosuppressant drugs are infection and increased risk of malignancy. Latent infections
with the tuberculosis bacillus or hepatitis B virus may become active infections during
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