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Internal Medicine • Rheumatology • Hematology • Systemic lupus erythematosus • Mycophenolate Mofetil • General Rheumatology • Scleroderma • Gastroenterology • Neurology • Nephrology • Neuro-immunology • Transplant nephrology
How do you counsel patients who experience diarrhea from mycophenolate mofetil (Cellcept)?
Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies?
Answer from: at Community Practice
I have them stop the drug, and when their bowels are back to normal (usually just a couple of days), I resume with 1 tablet bid of mycophenolate mofetil (MMF, CellCept), then a few days later go up to 1 tab tid, a few days later 2 tabs bid... etc. I instruct them to go down to the most recent dose...
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Answer from: at Community Practice
While not uniformly the case, mycophenolic acid is much better tolerated with regard to GI symptoms than than the mycophenolate salt; absorption of mycophenolic acid is likely better as well for patients with constitutional or drug induced (PPI Rx associated) achlorhydria.