IN PATIENTS TO WHOM ORAL THERAPY CANNOT INITIALLY BE GIVEN, MYCOPHENOLATE MOFETIL MAY BE GIVEN FOR UP TO 14 DAYS BY IV. IT IS DISSOLVED IN GLUCOSE 5% TO A FINAL CONCENTRATION EQUIVALENT TO MYCOPHENOLATE MOFETIL 6 MG/ML, AND GIVEN OVER 2 HOURS THROUGH EITHER A CENTRAL OR PERIPHERAL VEIN.
PROPHYLAXIS OF ACUTE RENAL GRAFT REJECTION : IN ADULTS, BY MOUTH 1 G TWICE DAILY, USUALLY WITHIN 72 HOURS FOLLOWING TRANSPLANTATION; THE EQUIVALENT DOSE MAY BE GIVEN BY INTRAVENOUS INFUSION, BUT IS USUALLY STARTED WITHIN 24 HOURS AFTER TRANSPLANTATION. FOR PREVENTION OF RENAL GRAFT REJECTION IN CHILDREN AND ADOLESCENTS AGED 2 TO 18 YEARS A DOSE OF 600 MG/M2 MAY BE GIVEN BY MOUTH TWICE DAILY, UP TO A MAXIMUM OF 1 G TWICE DAILY; PATIENTS WITH A BODY-SURFACE OF 1.25 TO 1.5 M2 MAY BE GIVEN 750 MG TWICE DAILY. IN THE UK, THE BNFC ALLOWS FOR USE FROM 1 MONTH TO 18 YEARS AT 600 MG/M2 TWICE DAILY BY MOUTH OR INFUSION WHEN USED WITH CICLOSPORIN AND CORTICOSTEROIDS, BUT RECOMMENDS 300 MG/M2 TWICE DAILY WHEN USED WITH TACROLIMUS AND CORTICOSTEROIDS; THE MAXIMUM IN BOTH CASES IS 2 G DAILY.
PROPHYLAXIS OF CARDIAC GRAFT REJECTION : IN ADULTS, MYCOPHENOLATE MOFETIL 1.5 G TWICE DAILY IS GIVEN BY MOUTH, WITHIN 5 DAYS AFTER TRANSPLANTATION, OR BY INTRAVENOUS INFUSION AT AN EQUIVALENT DOSE.
PROPHYLAXIS OF REJECTION IN HEPATIC TRANSPLANTATION : IN ADULTS, THE EQUIVALENT OF MYCOPHENOLATE MOFETIL 1 G TWICE DAILY IS GIVEN BY INTRAVENOUS INFUSION FOR THE FIRST 4 DAYS FOLLOWING TRANSPLANTATION, WITH SUBSEQUENT CONVERSION TO 1.5 G TWICE DAILY BY MOUTH AS SOON AS IT CAN BE TOLERATED. IN THE UK, THE BNFC RECOMMENDS 10 MG/KG TWICE DAILY, BY MOUTH OR INTRAVENOUS INFUSION, FOR CHILDREN FROM 1 MONTH TO 18 YEARS. THIS MAY BE INCREASED TO 20 MG/KG TWICE DAILY, TO A MAXIMUM OF 2 G DAILY. THE DOSE IS THE SAME WHETHER USED WITH EITHER CICLOSPORIN AND CORTICOSTEROIDS OR TACROLIMUS AND CORTICOSTEROIDS.
PATIENTS SHOULD UNDERGO REGULAR BLOOD COUNTS; IF NEUTROPENIA DEVELOPS CONSIDERATION SHOULD BE GIVEN TO INTERRUPTING MYCOPHENOLATE TREATMENT, REDUCING THE DOSE, OR STOPPING THERAPY.