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Cellcept vs Myfortic
Introduction
For patients who have undergone organ transplantation, specific drugs that modify the immune response can help prevent rejection and ensure the body accepts the new organ. Cellcept (Mycophenolate mofetil) and Myfortic (Mycophenolic acid) are two such immunosuppressant medications commonly prescribed post-transplantation. Both of these work by inhibiting an enzyme necessary for DNA synthesis in T and B cells, which play a crucial role in immune responses, thereby reducing their proliferation and dampening the immune response against the transplanted organ. While Cellcept is metabolized into Mycophenolic acid within liver tissues, Myfortic directly delivers this active substance without requiring metabolic conversion—hence potentially providing more predictable results with fewer side effects related to metabolism disturbances. Remember that both medications should be used under medical supervision due to their profound impact on your immune system.
Cellcept vs Myfortic Side By Side
| Attribute | Cellcept | Myfortic |
|---|---|---|
| Brand Name | Cellcept | Myfortic |
| Contraindications | Should not be taken if using azathioprine (Imuran) | Should not be taken if using azathioprine (Imuran) |
| Cost | Around $400 for 60 tablets of 500 mg | About $950 for 120 capsules of 180 mg |
| Generic Name | Mycophenolate mofetil | Mycophenolic acid |
| Most Serious Side Effect | Increased susceptibility to infection and certain types of cancer | Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling in your face, lips, tongue or throat |
| Severe Drug Interactions | Azathioprine needs at least 8 weeks to clear from the system before starting treatment with Cellcept to prevent dangerous interactions | Azathioprine needs at least 8 weeks to clear from the system before starting treatment with Myfortic to prevent dangerous interactions |
| Typical Dose | 1–3 g/day, divided into two doses | 720 mg to 1440 mg/day, divided into two doses |
What is Cellcept?
Mycophenolate mofetil (the generic name for Cellcept) and Mycophenolic acid (the generic name for Myfortic) are both immunosuppressant drugs. They are designed to prevent the body from rejecting a transplanted organ, such as the heart, kidney or liver. These medications serve an essential role in transplant medicine by reducing immune system activity.
Cellcept was first approved by the FDA in 1995, while its counterpart, Myfortic got approval later on. The main difference between these two lies in their formulation: Cellcept is available as capsules, tablets or oral suspension whereas Myfortic comes only as delayed release tablets which results into fewer gastrointestinal side effects compared to Cellcept. Both drugs limit immune responses by inhibiting an enzyme crucial for DNA synthesis in T and B cells but do not affect other cells that use different pathways for proliferation.
While both can be effective at preventing organ rejection after transplantation, they carry risks of serious side effects including increased susceptibility to infection and certain types of cancer due to suppressed immunity.
What conditions is Cellcept approved to treat?
Cellcept is approved for the prevention of organ transplant rejection:
- Kidney transplant (in combination with other drugs, such as cyclosporine and corticosteroids)
- Heart transplant (in combination with other drugs including cyclosporine and corticosteroids)
- Liver transplant (with concurrent administration of cyclosporine and corticosteroids)
How does Cellcept help with these illnesses?
Cellcept works to prevent organ rejection in patients who have received a transplant by reducing the activity of the body's immune system. It does this by inhibiting an enzyme called inosine monophosphate dehydrogenase (IMPDH) that is crucial for the proliferation of T and B cells, which are key components of your immune response. By blocking IMPDH, Cellcept interferes with DNA synthesis and restricts cell replication, thus dampening down the immune response.
Myfortic operates on a similar mechanism but it's more gut-friendly as it has been designed to reduce gastrointestinal side effects often associated with Cellcept use. Myfortic is actually an enteric-coated formulation of mycophenolate sodium, which means that it doesn't dissolve until reaching the intestines - hence less stomach upset.
Although both Cellcept and Myfortic limit overactive immune responses (and therefore help to prevent organ rejection), they differ primarily in their chemical formulation and how they are metabolized within your body. These differences can contribute to variations in effectiveness or side-effect profiles between individual patients.
What is Myfortic?
Myfortic is a brand name for mycophenolic acid, which is an immunosuppressant drug used to prevent the body's immune system from rejecting a transplanted organ. Myfortic functions by inhibiting inosine monophosphate dehydrogenase (IMPDH), an enzyme crucial for the proliferation of T and B lymphocytes. This action reduces their reactivity and thus lessens the likelihood of organ rejection. Approved by the FDA in 2004, Myfortic has been proven effective in maintaining kidney transplant success when combined with other immunosuppressants.
Unlike Cellcept, another type of mycophenolate mofetil medication that also works as an immunosuppressive agent, Myfortic is enteric-coated which allows it to be released directly into the small intestine rather than stomach; this can lead to better gastrointestinal tolerability compared to Cellcept. Potential side effects include diarrhea, leukopenia (low white blood cell count), sepsis or infection due to its suppression on immune response - these are common among many types of immunosuppressants like Cellcept but could potentially be less severe with Myfortic use due its specific delivery method.
What conditions is Myfortic approved to treat?
Myfortic is a medication approved for use in the prevention of organ rejection after kidney transplantation. It does this by suppressing the body's immune response to recognize and reject newly transplanted organs. The conditions treated with Myfortic include:
- Prophylaxis of organ rejection in patients receiving allogeneic renal transplants, used concomitantly with cyclosporine and corticosteroids.
Please note that while both Cellcept and Myfortic have similar treatment goals, they may vary in terms of dosing schedules, side effect profiles, and other factors which should be discussed thoroughly with your healthcare provider.
How does Myfortic help with these illnesses?
Myfortic, like CellCept, is a medication used to prevent organ rejection in individuals who have undergone an organ transplant. It works by suppressing the immune system and reducing its ability to attack the new organ. Myfortic operates on a similar mechanism as CellCept - both inhibit inosine monophosphate dehydrogenase (IMPDH), which plays a crucial role in the proliferation of T and B lymphocytes. However, Myfortic has an enteric coating that allows it to be absorbed later in the gastrointestinal tract, which can potentially lead to fewer side effects such as stomach upset when compared with CellCept.
How effective are both Cellcept and Myfortic?
Both mycophenolate mofetil (CellCept) and mycophenolic acid (Myfortic) are immunosuppressant drugs that have a long history of effectiveness in preventing organ rejection, specifically for kidney transplants. They were both approved by the FDA within a span of ten years from each other, CellCept in 1995 and Myfortic in 2004. Since they act on the same enzyme, inosine monophosphate dehydrogenase, they may be prescribed under similar circumstances.
A study conducted in 2011 involving renal transplant recipients demonstrated that Cellcept and Myfortic had comparable efficacy rates at preventing acute graft rejection as well as similar safety profiles - none of the different metrics studied to evaluate efficacy between patients receiving either medication showed significant differences.
In terms of side effect profile, however, there is some divergence. A meta-analysis carried out over multiple trials reported less gastrointestinal-related symptoms with Myfortic compared to Cellcept. This could make it more tolerable for certain populations who might be prone to such side effects.
Despite these slight differences, it's important to note that both medicines are considered first-line treatment options for renal transplant recipients due to their proven efficacy records. While there is ongoing research into other potential uses for these medications beyond transplantation medicine; currently their primary application remains focused around this area.
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At what dose is Cellcept typically prescribed?
Oral dosages of CellCept range from 1–3 g/day, typically divided into two doses. Research suggests that 2 g/day is effective for preventing organ rejection in most adults post-transplantation. Children and adolescents' dosage is usually calculated based on body surface area (BSA), starting with about 600 mg/m^2 per dose, given twice daily. Dosage can be adjusted depending upon the response and tolerance level of the individual patient. However, the maximum dosage should not exceed 4g/day under any circumstances.
On the other hand, Myfortic dosing starts at about 720 mg twice a day for adults undergoing renal transplantation which can be increased or decreased based on clinical outcomes but it should never exceed more than 1440 mg per day.
At what dose is Myfortic typically prescribed?
Myfortic treatment is typically initiated at a dosage of 720 mg to 1440 mg/day, divided into two doses, taken at least 12 hours apart. The dose can then be adjusted depending on the patient's response and tolerance level. The maximum recommended daily dose is 2160 mg (1080 mg twice daily), which may be evaluated if there is insufficient response to the initial treatment after some time. It's important to take Myfortic consistently either with or without food due to its absorption rate being affected by intake of meals. However, always follow your healthcare provider's instructions regarding medication administration.
What are the most common side effects for Cellcept?
Common side effects of Cellcept might include:
- Stomach upset or pain
- Nausea and vomiting
- Diarrhea
- Constipation
- Loss of appetite (Anorexia)
- Swelling in your hands, ankles, or feet
- Tremor (unintentional trembling or shaking)
- Headache, dizziness
Meanwhile, Myfortic may cause some different side effects such as:
- Abdominal pain
- Diarrhea
- Nausea and Vomiting
- Urinary tract infection.
Please note that both drugs can lower the ability of your immune system to fight infections which may lead to serious, possibly fatal infections. If you notice any signs of an infection like fever/chills/cough/persistent sore throat/night sweats/weight loss/warm/red/painful skin sores on your body/increased urination/tiredness/fatigue/fast heartbeat/easy bruising/bleeding/swollen glands around neck/armpits/groin consult with a healthcare professional immediately.
Are there any potential serious side effects for Cellcept?
While Cellcept and Myfortic are both immunosuppressant drugs, there are some differences in the side effects that you should be aware of:
- Experiencing any unusual bleeding or bruising
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Changes in vision including blurred vision, sensitivity to light
- Abnormal heartbeat rhythms: fast or pounding heartbeats; feeling like you might pass out.
- low white blood cell counts - fevers, mouth sores, skin sores, flu-like symptoms; severe nervous system reaction - muscle weakness on one side of your body decreased consciousness
- Symptoms suggestive of infections such as fever, chills persistent coughs which may indicate pneumonia
- Any indications of stomach ulcers: severe abdominal pain accompanied by nausea and vomiting.
If you experience any of these while taking either drug it's critical to seek medical attention immediately.
What are the most common side effects for Myfortic?
When comparing Cellcept to Myfortic, it's important to note that the use of Myfortic can potentially lead to a variety of side effects including:
- Upset stomach or vomiting
- Diarrhea and loss of appetite
- Difficulty sleeping (insomnia)
- High blood pressure
- Tremors or anxiety
- Possible skin rashes
- Potential weight loss due to gastrointestinal issues
- An increased frequency in urination
- Headaches or feelings of dizziness It's also worth mentioning that some patients may experience joint pain while on this medication. Always discuss these potential side effects with your healthcare provider before starting treatment with Myfortic.
Are there any potential serious side effects for Myfortic?
Myfortic, much like any other medication, can cause a range of side effects. Some symptoms could indicate potentially serious health problems:
- Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling in your face, lips, tongue or throat
- Evident signs of infection: fever, chills, body aches and pains
- High blood sugar levels that may present with increased thirst and urination
- Severe nausea or vomiting coupled with loss of appetite
- Difficulty passing urine or changes in the amount being passed
- Swelling around your midsection paired with rapid weight gain
If you experience these side effects while taking Myfortic it is important to seek immediate medical attention.
Contraindications for Cellcept and Myfortic?
Both Cellcept and Myfortic, like most medications used to prevent organ transplant rejection, may lead to a higher risk of developing infections or lymphoma and other cancers. If you notice signs of infection such as fever, chills, persistent sore throat/cough; swollen glands; changes in skin coloration or growths on your skin; night sweats; unexplained weight loss or tiredness please contact your healthcare provider immediately.
Neither Cellcept nor Myfortic should be taken if you are using azathioprine (Imuran). Always inform your physician about all the medication that you are currently taking including any recent vaccinations. Azathioprine needs at least 8 weeks to clear from the system before starting treatment with either Cellcept or Myfortic to prevent dangerous interactions between these drugs.
How much do Cellcept and Myfortic cost?
The cost of brand-name versions of these immunosuppressant drugs:
- The price for 60 tablets of CellCept (500 mg) averages around $400, which works out to approximately $13.33/day, depending on your dose.
- The price for 120 capsules of Myfortic (180 mg) is about $950, working out to approximately $31.66/day.
If you are in the higher dosage range for CellCept (for instance, 2000 mg per day), then brand-name Myfortic can be less expensive on a per-day treatment basis if you're prescribed doses over 720mg daily. It's important to remember that cost should not be the primary consideration when choosing between these two medications; effectiveness and side effects play crucial roles as well.
For their generic counterparts:
- Mycophenolate mofetil (generic version of CellCept) costs significantly less with prices ranging from around $0.50 to $1.00 per tablet.
- There's no available generic form for mycophenolic acid or Myfortic at this time.
Please consult with your healthcare provider to discuss what medication would best suit your needs and budget before making any decisions based purely on financial considerations.
Popularity of Cellcept and Myfortic
Mycophenolate mofetil, available under the brand name CellCept, and mycophenolic acid sold as Myfortic are immunosuppressive drugs largely prescribed to prevent organ rejection in patients who have undergone kidney, liver, or heart transplants. In 2020, about 450 thousand prescriptions were dispensed for CellCept while approximately 200 thousand prescriptions were given out for Myfortic in the United States.
CellCept accounted for over half of all mycophenolate prescriptions that year. It has been a standard choice since it was approved by FDA in late 90s. Expanding its use beyond transplantation medicine into rheumatology and dermatology departments attributes to the steady increase in prescription numbers over recent years.
Contrarily, Myfortic with just under a quarter of total mycophenolate prescriptions has had steadier usage patterns. Introduced later than it's counterpart Cellcept – early 2000s - , it is often used when gastrointestinal side effects can't be managed with Cellcept due to its enteric coating which allows dissolution at more alkaline pH like that found in the small intestine.
Conclusion
Both Cellcept (mycophenolate mofetil) and Myfortic (mycophenolic acid) are immunosuppressant medications used to prevent organ rejection in patients who have undergone kidney, liver, or heart transplants. They work by inhibiting a specific pathway that is crucial for the growth of T and B cells, which are involved in immune responses.
Cellcept is typically administered twice daily while Myfortic has a slow-release formulation designed for more consistent blood levels throughout the day with once-daily administration. The choice between these two drugs often depends on individual patient factors such as tolerability, convenience of dosing schedule, and cost considerations.
Both drugs come in generic forms offering potential cost savings for patients paying out-of-pocket. Like with any medication adjustment period may be required to reach optimal efficacy.
The side effect profiles of both drugs are similar including gastrointestinal problems like diarrhea and vomiting being most common but also include serious effects like increased risk of infection due to their immunosuppressive action. Patients using either drug should closely monitor their health status and seek medical attention promptly if they notice symptoms suggesting infection or other adverse effects.
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Refrences
- Feng, J. J., Zhang, L. W., Zhao, P., Bow, L. M., & Tian, J. (2015, May). Enteric-coated mycophenolate sodium given in combination with tacrolimus has a lower incidence of serious infections in Asian renal-transplant recipients compared with mycophenolate mofetil. International Journal of Clinical Practice. Wiley.http://doi.org/10.1111/ijcp.12660
- Mele, T. S., & Halloran, P. F. (2000, May). The use of mycophenolate mofetil in transplant recipients. Immunopharmacology. Elsevier BV.http://doi.org/10.1016/s0162-3109(00)00190-9
- Arns, W. (2007, January). Noninfectious Gastrointestinal (GI) Complications of Mycophenolic Acid Therapy: A Consequence of Local GI Toxicity?. Transplantation Proceedings. Elsevier BV.http://doi.org/10.1016/j.transproceed.2006.10.189
- Rutkowski, B., Bzoma, B., Dębska-Ślizień, A., & Chamienia, A. (2011). Immunosuppressive regimens containing generic mycophenolate mofetil (Myfenax) in de novo renal transplant recipients – preliminary results of 6-month observation. Annals of Transplantation. International Scientific Information, Inc.http://doi.org/10.12659/aot.882222
- Okamoto, M., Wakabayashi, Y., Higuchi, A., Kadotani, Y., Ogino, S., Ushigome, H., … Yoshimura, N. (2005, March). Therapeutic Drug Monitoring of Mycophenolic Acid in Renal Transplant Recipients. Transplantation Proceedings. Elsevier BV.http://doi.org/10.1016/j.transproceed.2004.12.238
- Massari, P., Duro-Garcia, V., Girón, F., Hernández, E., Juárez, F., Castro, C., & Toledo, M. (2005, March). Safety Assessment of the Conversion From Mycophenolate Mofetil to Enteric-Coated Mycophenolate Sodium in Stable Renal Transplant Recipients. Transplantation Proceedings. Elsevier BV.http://doi.org/10.1016/j.transproceed.2004.12.020
- Lee, P.-C., Chang, S.-S., Shieh, S.-C., Wu, Z.-C., Wang, W.-M., Wang, J.-D., … Chan, R.-H. (2012, January). Cyclosporine or Tacrolimus: Which Is the Better Partner for Myfortic or CellCept?. Transplantation Proceedings. Elsevier BV.http://doi.org/10.1016/j.transproceed.2011.12.023