Mycophenolate mofetil is generally well tolerated. The commonly reported adverse effects include gastrointestinal, hematological, and genitourinary.

Diarrhea is the most common gastrointestinal adverse effects noted, followed by nausea and vomiting. Abdominal cramps may occur in certain cases. Typically, these side effects occur early in the treatment course and reduce with continued use (Behrend M, 2001). The adverse events are more common in transplant patients than those with inflammatory diseases (Goldblum R, 1993). The majority of gastrointestinal symptoms are mild and if persisting, it is necessary to exclude other possibilities such as enteric opportunistic infection, gastrointestinal ulceration, and bleeding.

Mycophenolate mofetil does not produce significant hepatotoxicity, however mildly elevated liver transaminases may be observed (Hantash B & Fiorentino D 2006).

Leukopenia is also very common and there are case reports of the occurrence of anemia and thrombocytopenia. However, these adverse effects are relatively uncommon when compared to AZA.

Rare side effects include fever, myalgia, neurologic side effects such as headache and insomnia, and cardiovascular effects such as peripheral edema and hypertension. In addition, cutaneous effects like acne, urticaria and dyshidrotic eczema have been reported (Szyper- Kravitz M et al. 2005).

Similar to AZA, the drug increases the risk of contracting viral, bacterial and mycobacterial infections (Ensley RD et al. 1993).

REFERENCES

1. Behrend Adverse gastrointestinal effects of mycophenolate mofetil: aetiology, incidence and management. Drug Saf. 2001;24(9):645-63.
2. Goldblum R. Therapy of rheumatoid arthritis with mycophenolate mofetil.Clinical and Experimental  1993; 11 (8):S117-119.
3. Hantash B, Fiorentino D. Liver enzyme abnormalities in patients with atopicdermatitis treated with mycophenolate  Arch Dermatol 2006 Jan: 142 (1): 109–110.
4. Szyper-KravitzM, Sheinberg P, Sidi Y, Schiffenbauer Y, Trubniykov E, Shoenfeld  Hypersensitivity to mycophenolate mofetil in systemic lupus erythematosus: diagnostic measures and successful desensitization. Int Arch Allergy Immunol 2005;138 (4): 334–336.
5. EnsleyRD, Bristow MR, Olsen SL, et  The use of mycophenolate mofetil (RS- 61443) in human heart transplant recipients. Transplantation 1993;56(1): 75–82.