Usage And Safety
Dosage
Adults : A dose of 1 g administered orally twice a day (daily dose of 2 g) is recommended for use in renal transplant patients ; Cardiac Transplantation : Adults: A dose of 1.5 g twice a day oral (daily dose of 3 g) is recommended for use in adult cardiac transplant patients ; Hepatic Transplantation Adults : A dose of 1.5 g twice a day oral (daily dose of 3 g) is recommended for use in adult hepatic transplant patients . Elderly : The recommended oral dose of 1 g twice a day for renal transplant patients, 1.5 g twice a day for cardiac transplant patients, 1.5 g twice a day administered orally in hepatic transplant patients is appropriate for elderly patients. OR As directed by your physician.
Side Effects
Diarrhoea, vomiting, GI haemorrhage and perforation; leukopenia; asthenia, pain, headache, anaemia, thrombocytopenia, renal tubular necrosis, haematuria, BP changes, hyperglycaemia, disturbances of electrolytes and blood lipids, peripheral oedema, dyspnoea, cough, acne, rash, alopecia, dizziness, insomnia, paraesthesia, tremor, hypersensitivity reactions, pancreatitis, hepatitis. Potentially Fatal: Angioedema, anaphylaxis, fatal pulmonary fibrosis.
Drug Interactions
Aciclovir, valaciclovir, ganciclovir and valganciclovir , colestyramine, magnesium – aluminium hydroxide-containing products, sevelamer and other calcium-free phosphate binders , ciclosporin, metronidazole, quinolones, rifamycins , probenecid. May reduce efficacy of live vaccines.
Indication
It is indicated for the prophylaxis of organ rejection in patients receiving allogeneic renal, cardiac or hepatic transplants. Mycolate should be used concomitantly with cyclosporine and corticosteroids .
When not to Use
Hypersensitive to any of the ingredient , Pregnancy, lactation. Rare hereditary deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT), including Kelley-Seegmiller or Lesch-Nyhan syndrome.
Warnings
Warning 1
Increased risk of lymphoma and increased susceptibility to infection may be related to immunosuppression.
Warning 2
Administration is associated with increased risk of pregnancy loss and congenital malformations. Women of childbearing potential must use contraception .
Warning 3
Perform CBCs weekly during the first month, twice monthly during the second and third months, then monthly through the first year. Monitor patient for signs and symptoms of bacterial, viral, or fungal infections, and for signs and symptoms of organ rejection.
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