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Brand names: CellCept (mofetil) / Myfortic (sodium) • Drug class: Antiproliferative immunosuppressant (IMP dehydrogenase inhibitor)
Mycophenolate is the standard second immunosuppressant in kidney transplant (paired with tacrolimus) and a key treatment in lupus nephritis and other glomerular diseases. It blocks the immune cells that would attack the graft or drive autoimmune kidney damage.
Mycophenolate attacks a different immune pathway than tacrolimus, so the two combine to prevent rejection at lower individual doses. In lupus nephritis it is first-line therapy (induction and maintenance), and it is used in ANCA vasculitis and relapsing nephrotic syndrome as a steroid-sparing agent.
Mycophenolate is first-line induction and maintenance therapy in lupus nephritis (comparable to cyclophosphamide with better tolerability)
ALMS trial, 2005
Standard combination immunosuppression with tacrolimus reduces rejection rates in kidney transplant
Transplant trials (SYMPHONY et al.), 2000s
Teratogenic — must be stopped before conception and replaced with azathioprine in pregnancy planning
Transplant pregnancy guidance (KDIGO 2020), 2020
Dose is adjusted for kidney function and blood counts — leukopenia (low white cells) means reducing. In transplant, typical dosing is 500-1000 mg twice daily with dose adjustments by white count and GI tolerance.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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