Main indications in lupus

Mycophenolate Sodium does not have a marketing authorization in lupus, but experts recognize efficacy in severe lupus, especially in cases of severe renal or visceral involvement.

Dosage

- Tablets of 180 and 360 mg, oral solution (1 mg / ml); no IV form

- 1440 mg/day in 2 doses in between meals

Main drug interactions (combinations to avoid)

- Bile acid sequestrants

- Aciclovir, ganciclovir

- Antacids containing aluminium hydroxide or magnesium

Main side effects

- Diarrhoea, abdominal pain

- Lesion of the colon wall (ischemic colitis) very rare

- Abnormalities of the liver test

- Cytopenia: decrease in blood cells in the bloodstream (leukopenia)

- Infections (viral (CMV), bacterial...)

- Rare occurrence of skin tumours

- Fatigue (asthenia)

Contraindications

- Pregnancy, lactation, hypersensitivity

- Ongoing infection (temporary stop of treatment)

Precautions for use

- Need for effective contraception up to 6 weeks after stopping treatment

- Gradual increase in doses

- No association with antacids because risk of absorption problem

- Skin monitoring and consultation if an abnormal pimple appears that persists for more than 3 weeks

- In the absence of data in case of severe renal failure, close monitoring (usefulness of kinetics) to adapt doses if necessary

Monitoring

- Blood count (+/- liver assessment, creatinine): 1/week for 1 month, then 1/15 days for 2 months, and then 1/month

- Clinical monitoring