Consumer medicine information

Mycophenolate Sandoz

Mycophenolate mofetil

BRAND INFORMATION

Brand name

Mycophenolate Sandoz

Active ingredient

Mycophenolate mofetil

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Mycophenolate Sandoz.

What is in this leaflet

This leaflet answers some common questions about Mycophenolate Sandoz.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking this medicine against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine. You may want to read it again.

What Mycophenolate Sandoz is used for

Mycophenolate Sandoz contains the active ingredient mycophenolate mofetil.

Mycophenolate Sandoz belongs to a group of medicines called immunosuppressants.

Immunosuppressants are used to prevent rejection of transplanted organ and works by stopping your immune system from reacting to the transplanted organ.

There are many different types of medicines used to prevent rejection of a transplanted organ.

Mycophenolate Sandoz may be used together with other medicines known as ciclosporin and corticosteroids.

Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.

This medicine is available only with a doctor's prescription.

Mycophenolate Sandoz is not addictive.

Before you take Mycophenolate Sandoz

When you must not take it

Do not take this medicine if you have an allergy to:

  • mycophenolate mofetil, the active ingredient, or to any of the other ingredients listed at the end of this leaflet under Product description.

Some of the symptoms of an allergic reaction may include:

  • shortness of breath
  • wheezing or difficulty breathing
  • swelling of the face, lips, tongue or other parts of the body
  • rash, itching or hives on the skin.

Do not take this medicine if you are pregnant. Mycophenolate Sandoz is harmful to an unborn baby when taken by a pregnant woman. There have been cases of miscarriage and severe birth defects reported when patients have taken mycophenolate mofetil during pregnancy. You must tell your doctor if you are pregnant or plan to become pregnant.

Do not take this medicine if you are breastfeeding. Mycophenolate Sandoz may pass into human breast milk and cause serious side effects in your baby if you breastfeed.

Do not take this medicine if you are a woman who could become pregnant and you are not using two reliable forms of contraception. You must use two reliable forms of contraception at the same time before beginning mycophenolate mofetil therapy, during therapy and for at least six weeks after stopping mycophenolate mofetil, unless you are not sexually active.

Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you take this medicine after the expiry date has passed it may not work as well.

If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it

Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor if you are pregnant or plan to become pregnant.

If you are a woman of child bearing potential, you must have two negative pregnancy tests 8-10 days apart just prior to starting treatment with mycophenolate mofetil.

Repeat pregnancy tests will be performed during routine follow-up visits with your doctor.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Tell your doctor if you are a sexually active man.

You are recommended to use condoms during treatment and for 90 days after stopping treatment, even if you have had a vasectomy. Your female partner(s) are recommended to use reliable contraception while you are being treated with mycophenolate mofetil and for 90 days after you have stopped receiving mycophenolate mofetil.

You should not donate semen while you are being treated with Mycophenolate Sandoz and for 90 days after you have stopped receiving this medicine.

You should not donate blood while you are being treated with Mycophenolate Sandoz and for at least 6 weeks after you stop receiving this medicine.

Tell your doctor if you have or have had any of the following medical conditions:

  • a history of sun spots or skin cancers
  • a history of low blood counts of neutrophils (a type of white blood cell)
  • a history of serious stomach or bowel problems (such as ulcers or bleeding)
  • rare diseases due to a deficiency of the HGPRT enzyme such as Lesch-Nyhan or Kelley-Seegmiller syndrome
  • kidney disease.

If you have not told your doctor about any of the above, tell him/her before you start taking Mycophenolate Sandoz.

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and Mycophenolate Sandoz may interfere with each other. These include:

  • azathioprine, tacrolimus and sirolimus, medicines used to suppress the immune system which can be used to prevent organ rejection after a transplant
  • acyclovir, ganciclovir, valaciclovir or valganciclovir, medicines used to treat viral infections
  • isavuconazole, a medicine used to treat fungal infections
  • antacids, medicines used to treat heartburn and indigestion
  • proton pump inhibitors, medicines used to treat indigestion and stomach ulcers such as lansoprazole and pantoprazole
  • cholestyramine, a medicine used to treat high cholesterol
  • ciprofloxacin, amoxicillin plus clavulanic acid, norfloxacin plus metronidazole and rifampicin, medicines used to treat infections
  • iron supplements, medicines used to treat low iron levels in the blood
  • certain vaccines, (especially live vaccines), medicines that work by causing your body to produce its own protection against an infectious disease
  • calcium-free phosphate binders (such as sevelamer), medicines used to treat high phosphate levels in the blood.

These medicines may be affected by Mycophenolate Sandoz or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.

How to take Mycophenolate Sandoz

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions, ask your doctor or pharmacist for help.

How much to take

Take Mycophenolate Sandoz exactly as your doctor has prescribed. Your doctor will tell you how many Mycophenolate Sandoz capsules or tablets to take each day.

Ask your doctor or pharmacist if you are unsure of the correct dose for you. They will tell you exactly how much to take.

Follow the instructions they give you. If you take the wrong dose, Mycophenolate Sandoz may not work as well and your problem may not improve.

The dose to prevent organ rejection is usually 1 g to 1.5 g in the morning and 1 g to 1.5 g at night (2 g to 3 g per day) depending on which organ has been transplanted.

How to take it

Swallow the tablets/capsules whole with a glass of water.

Do not crush tablets or open or crush capsules. If a capsule breaks open accidentally, wash any powder off your skin with soap and water.

When to take Mycophenolate Sandoz

It is best to take doses of Mycophenolate Sandoz approximately 12 hours apart.

Take your medicine at about the same time each day. Taking it at the same time each day will have the best effect. It will also help you remember when to take it.

How long to take Mycophenolate Sandoz

This medicine should be taken every day. It is important to keep taking Mycophenolate Sandoz to ensure your new transplant keeps working properly.

Continue taking your medicine for as long as your doctor tells you.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take it as soon as you remember, and then go back to taking it as you would normally.

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you are not sure what to do, ask your doctor or pharmacist.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or the Poisons Information Centre (telephone Australia 13 11 26 or New Zealand 0800 POISON or 0800 764766) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Mycophenolate Sandoz. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

If you are not sure what to do, contact your doctor or pharmacist.

While you are taking Mycophenolate Sandoz

Things you must do

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Mycophenolate Sandoz.

Tell any other doctors, dentists, and pharmacists who treat you that you are taking this medicine.

If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine. It may affect other medicines used during surgery.

If you become pregnant while taking this medicine, tell your doctor immediately.

If you are a woman of child bearing potential, you must use two reliable forms of contraception at the same time before beginning mycophenolate mofetil therapy, during therapy and for at least six weeks after stopping mycophenolate mofetil, unless you are not sexually active.

If you are a sexually active male, you are recommended to use condoms during treatment and for 90 days after stopping treatment, even if you have had a vasectomy.

Your female partner(s) are recommended to use reliable contraception while you are being treated with mycophenolate mofetil and for 90 days after you have stopped receiving mycophenolate mofetil.

Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed. Otherwise, your doctor may think that it was not effective and change your treatment unnecessarily.

Tell your doctor if you feel your medicine is not helping your condition.

Keep all of your doctor's appointments so that your progress can be checked. Your doctor will need to give you regular blood tests.

Wear protective clothing and a broad-spectrum sunscreen when outdoors. Medicines that prevent rejection of transplants can increase the risk of skin cancers.

Things you must not do

Do not stop taking your medicine or change the dose without checking with your doctor.

Do not let yourself run out of medicine over the weekend or on holidays.

Do not give your medicine to anyone else, even if they have the same condition as you.

Do not take Mycophenolate Sandoz to treat any other complaints unless your doctor tells you to.

Do not crush Mycophenolate Sandoz tablets or open Mycophenolate Sandoz capsules.

Do not take any other medicines whether they require a prescription or not without first telling your doctor or consulting a pharmacist.

Things to be careful of

Be careful driving or operating machinery until you know how Mycophenolate Sandoz affects you experience somnolence, confusion, dizziness, tremor or hypotension. Mycophenolate Sandoz may affect your ability to drive a car or operate machinery.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Mycophenolate Sandoz.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.

Mycophenolate Sandoz helps most people who have transplants but it may have unwanted side effects in a few people.

To stop you rejecting your organ, transplant medications reduce your body's own defence mechanisms. This means your body will not be as good at fighting infection. People taking this medicine therefore develop more infections than usual.

Patients who receive immunosuppressant medicines may also have a small increase in their risk of developing some types of cancer. You should discuss this with your doctor.

If you are over 65 years of age you may have an increased chance of side effects occurring due to immunosuppression.

Do not be alarmed by the following lists of side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • diarrhoea, constipation, nausea (feeling sick) or indigestion
  • stomach, chest, back or other pain
  • headache
  • urinary infections.

The above list includes the more common side effects of Mycophenolate Sandoz.

If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

  • signs of other infections e.g. fevers, chills, sore throat or ulcers of the mouth, abdominal pain or bloody stools.
  • unexpected bruising or bleeding
  • signs of anaemia such as excessive tiredness, dizziness or looking pale
  • swelling of the hands, ankles or feet, lymph nodes.
  • Hypersensitivity
  • Breathing difficulties, pain in the chest, chronic cough with blood

The above list includes serious side effects. You may need urgent medical attention or hospitalisation. Serious side effects are rare.

This is not a complete list of all possible side effects. Others may occur in some people and there may be some side effects not yet known.

Tell your doctor or pharmacist if you notice anything that is making you feel unwell.

Other side effects not listed above may also occur in some people.

After taking Mycophenolate Sandoz

Storage

Keep your medicine in the original container.

If you take it out of its original container it may not keep well.

Keep your medicine in a cool dry place where the temperature stays below 30°C.

Do not store Mycophenolate Sandoz or any other medicine in the bathroom or near a sink. Do not leave it on a window sill or in the car. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

Product description

What Mycophenolate Sandoz capsules look like

Mycophenolate Sandoz 250 mg - capsules, blue on one end and orange on the other.

Available in blister packs of 100 capsules.

Ingredients

Active ingredients:

  • Mycophenolate Sandoz 250 mg - 250 mg mycophenolate mofetil

Inactive ingredients:

The capsule fill contains:

  • pregelatinised maize starch
  • croscarmellose sodium
  • povidone
  • magnesium stearate.

The capsule shell contains:

  • gelatin
  • titanium dioxide
  • iron oxide red
  • iron oxide yellow
  • indigo carmine.

What Mycophenolate Sandoz tablets look like

Mycophenolate Sandoz 500 mg - lavender coloured, capsule shaped tablets, plain on both sides.

Available in blister packs of 50 tablets.

Ingredients

Active ingredients:

  • Mycophenolate Sandoz 500mg - 500mg mycophenolate mofetil

Inactive ingredients:

  • microcrystalline cellulose
  • povidone
  • purified talc
  • croscarmellose sodium
  • magnesium stearate
  • hypromellose
  • hyprolose
  • titanium dioxide
  • macrogol 400
  • iron oxide black
  • iron oxide red.

Mycophenolate Sandoz tablets and capsules do not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Not all strengths or presentations may be marketed.

Supplier

Sandoz Pty Ltd
ABN 60 075 449 553
54 Waterloo Road
Macquarie Park, NSW 2113
Australia
Tel: 1800 726 369

Novartis New Zealand Ltd
PO Box 99102
Newmarket, Auckland 1149
New Zealand
Tel: 0800 354 335

This leaflet was revised in April 2021.

Australian Register Number(s)

  • Mycophenolate Sandoz 250 mg capsules - AUST R 148227 (blisters)
  • Mycophenolate Sandoz 500 mg tablets - AUST R 148225 (blisters)

Published by MIMS June 2021

BRAND INFORMATION

Brand name

Mycophenolate Sandoz

Active ingredient

Mycophenolate mofetil

Schedule

S4

 

1 Name of Medicine

Mycophenolate mofetil (MMF).

2 Qualitative and Quantitative Composition

Each Mycophenolate Sandoz 250 mg capsules contains 250 mg mycophenolate mofetil.
Each Mycophenolate Sandoz 500 mg tablets contains 500 mg mycophenolate mofetil.
MMF is a white to off-white crystalline powder.
For the full list of excipients, see Section 6.1 List of Excipients.
Not all strengths may be marketed in Australia.

3 Pharmaceutical Form

Mycophenolate Sandoz 250 mg capsules. Blue opaque cap with orange opaque body, containing white to off white coloured powder.
Mycophenolate Sandoz 500 mg tablets. Capsule shaped, lavender coloured, film-coated biconvex tablet, plain on both sides.
Not all strengths may be marketed in Australia.

4 Clinical Particulars

4.9 Overdose

Reports of overdoses with MMF have been received from clinical trials and during post-marketing experience. In many of these cases no adverse events were reported. In those overdose cases in which adverse events were reported, the events fall within the known safety profile of the medicine.
It is expected that an overdose of MMF could possibly result in over-suppression of the immune system and increase susceptibility to infections and bone marrow suppression (see Section 4.4 Special Warnings and Precautions for Use). If neutropenia develops, dosing with MMF should be interrupted or the dose reduced (see Section 4.4 Special Warnings and Precautions for Use).
MPA cannot be removed by haemodialysis. However, at high MPAG plasma concentrations (> 100 microgram/mL), small amounts of MPAG are removed. Bile acid sequestrants, such as colestyramine, can remove MPA by increasing excretion of the drug (see Section 5.2 Pharmacokinetic Properties).
Treatment of overdosage should consist of general supportive measures.
For information on the management of overdose, contact the Poisons Information Centre on 131126 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. MMF did not induce point mutations (Ames assay) or primary DNA damage (yeast mitotic gene conversion assay) in the presence or absence of metabolic activation. MMF did not cause chromosomal damage in vivo at oral doses up to 3000 mg/kg (mouse micronucleus aberration assay) or in vitro with or without metabolic activation at concentrations up to 5 microgram/mL (Chinese hamster ovary cell [CHO] chromosomal aberration assay). Chromosome aberrations were present without metabolic activation in an initial CHO cell assay, but only at concentrations (249 to 300 microgram/mL) that cause excessive cytotoxicity.
Carcinogenicity. A 104 week oral carcinogenicity study in mice with MMF at daily doses of 25, 75 or 180 mg/kg showed an increase above control levels in the incidence of lymphosarcomas in females at the highest two dose levels and in males at the highest dose level (1.1-1.9 times the expected maximum clinical dose based on AUC values). The incidence of lymphosarcomas in all mice remained within the range of that observed historically in this strain of mice. In a 104 week oral carcinogenicity study in rats, MMF in daily doses up to 15 mg/kg (0.6 times the expected maximum clinical dose based on AUC values) was not tumourigenic.
The incidence of lymphoma/ lymphoproliferative disease and other malignancies is also increased in patients on immunosuppressive agents, and this appears to be related to the intensity or duration of immunosuppression rather than any specific immunosuppressant agent (see Section 4.4 Special Warnings and Precautions for Use).

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

MMF is freely soluble in dimethyl sulfoxide, tetrahydrofuran, acetone, acetonitrile, dichloromethane and ethyl acetate; soluble in methanol and propylene carbonate; sparingly soluble in anhydrous ethanol; slightly soluble in 2-propanol, diethyl ether and very slightly soluble in hexane. It is practically insoluble in water (43 microgram/mL at pH 7.4); the solubility increases in acidic medium (4.27 mg/mL at pH 3.6).
Chemical structure.
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSMYCMOF.gif Chemical name: 2-morpholinoethyl(E)-6-(1,3-dihydro-4-hydroxy-6-methoxy-7-methyl-3-oxo-5-isobenzofuranyl)-4-methyl-4-hexenoate.
Molecular formula: C23H31NO7.
Molecular weight: 433.5.
CAS number. 115007-34-6.

7 Medicine Schedule (Poisons Standard)

S4 - Prescription Only Medicine.

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/MYCSANST.gif