Different brands of Mycophenolate Mofetil. Anyone have any problems?

[Wendy39]

I have been on MMF 3g a day for a few months now. Started 1g a day in July and increased. I was given Myfenax 500mg film coated tablets until the beginning of December, but when I put my prescription in for Christmas and New Year tablets, I have been given Accord and also Actavis.

I may not get any problems, but am weary of what to look out for.

I had problems with hydroxychloroquine when they switched me to unbranded types, especially Quinoric - extremely unpleasant, I suffer with IBS type issues and diarrhoea but Quinoric was beyond. So now, my GP has written on my prescription, Zentiva brand only.

Anyone have any problems with these brands?

[EOLHPC]

Good question Wendy...I've been wondering about other makes of MMF too. My repeat prescrip specifies mycophenolate cellcept because of my chronic GI probs. And I've had to get my gp to specify zentiva hydroxy too

🍀🍀🍀🍀 coco

[Wendy39 in reply to EOLHPC]

Hello coco. I've never had Cellcept. Is that the "proper" one? Is Myfenax an unbranded? My bowel issues are very up and down but wondering if changing brands all the time will be good or bad too. Would like to stick to one with the least GI problems. X

[Hidden in reply to Wendy39]

I'm nearly two weeks into the Tiva brand Myfenax. It gave me the runs for a few days abs nausea too, but as it's the only brand I've tried I don't know how it compares to others. I'm absolutely fine on it now but still got to move up to double the dosage. It does say Mycophenolate Mofetil underneath as you will know. The pharmacist said she could give me an alternative if I continued to feel sick and have the runs, but as I said in my recent post - things are now healthy in that department for first time in over a year!

When all went pear shaped with Hydroxy for me, after 14-18 months, I was on Hydroxichloraquine. I don't know which pharma company made it though. I wish I'd asked to try different brands now as it gave me a slow form of anaphylaxis. I did have a very nasty facial rash when I took Plaquenil the same day as my Methotrexate though so I'm guessing that it's not the fillers I'm usually allergic to but the the drug itself. Sorry can't be of more help.x

[EOLHPC in reply to Wendy39]

It's interesting, Wendy...when I started myco in Jan 2014 via my lupus clinic writing with instructions re Shared Care Guidelines between my hospital & GP surgery, only mycophenolate mofetil was specified

As I understand it, Cellcept is the Brand of Mycophenolate mofetil (MMF), just as Myfortic is the Brand of Mycophenolate sodium. These are the 2 Brands of these 2 types of myco. Otherwise there are generics...and these are what you're being prescribed

I know the chemical action is quite different between Myco sodium Myfortic & myco mofetil Cellcept. Myfortic is less prescribed, usually just to patients who can't get on with MMF.

I'd heard from others on our forum that Cellcept is more expensive than generic MMF, and tends to be easier to tolerate, so I was relieved my gp gave this to me from the start, and has never tried to replace this with a generic (cellcept is specified on my repeat list). Even so, my chronic upper GI conditions did flare during my first 3 months on myco (oesophagitis + gastritis)...but my chronic lower GI stuff seemed unaffected. Whereas a close local lupus friend was switched to Myfortic because Cellcept gave her persistent diarrhoea.

Hope something in there is helpful. I've been watching out for posts about generic myco here....my experience of generics generally is that I can sometimes react badly to various fillers differing between their versions of a med (e.g. I stick to zentiva hydroxy, and also certain antibiotics made by particular companies). I may've missed something, but I think your post is the first about generic MMF since I joined in 2011....I get the impression Accord & Actavis are simply manufacturing company names

I hope something in there is useful to you...and I'm glad twitchy has replied to your question too

🍀🍀🍀🍀

[Fennella02]

I have only ever been given Cellcept but, from what I have read, different manufacturers use different fillers and binders to hold the MMF in a tablet shape. The tablets must all contain the prescribed amount of drug but some people do not get on well with certain fillers/binders and, perhaps less well known, people can be allergic to the different dyes that are used to colour the tablets.

[Hidden]

Well I can tell you that Myfenax are film coated and are an off white colour. Like all my current prescription meds apart from AdCal, the company who makes it is Teva. They've just had a lot of negative publicity for hiking the cost of Hydrocortizone astronomically. news.sky.com/story/firm-acc...

The same thing about fillers is often said on the Thyroid UK forum re allergies from Levothyroxine brands but, despite being highly allergic to many drugs myself, I've never felt I had an allergy to any of the different brands of Levothyroxine I've been given over the years - although they are relatively tiny pills compared to Myco.

2 DMARDs have given me anaphylaxis and I think I have an allergy to drugs containing sulphur. Also Amlodopine and Nifedipine affected my skin badly and I started to swell I knew to stop. I used to notice that my reaction to Methotrexate would vary from week to week. I was fine for six months on various different brands and then my dose was increased and boom - I felt I was dying after my weekly dose of pills, got sick bug, cold and chest infection and felt sick ever after even after switching to injections at much lower dose. My reactions were totally unpredictable from week to week - some weeks mildly nauseous for a day, other weeks sick as a dog both ends for 4-5 days. That's what made it unsustainable for me.

Consequently I never take any drug for granted now and, while I am mightily relieved that Myfenax and I are getting on great for now, I'm mindful that this could easily change. And if it does I'm reasonably confident that it will be the drug not the fillers that I react positively or negatively to. Twitchy x

[EOLHPC]

This link takes you to a website that compares meds....and gives further links to more details about the meds being compared...and also to online discussions about these meds

Of course, this is often of limited value, so I look at its reports with some skepticism ...but, whatever, it's interesting up to a point 😉😘🍀

So, for what's worth, here for instance is what this comparison site has on cellcept & myfenax:

treato.com/CellCept,Myfenax...

[Fennella02]

I live between 2 Boots pharmacies. One of them told me that they were only permitted to dispense generic MMF unless the script stipulated Cellcept (which, on that occasion, mine did not). They had, on that day, run out of the generic but had loads of Cellcept but refused to fulfil my prescription nevertheless. I drove 5 miles to the other Boots who told me that they only ever stock Cellcept . . .

[EOLHPC in reply to Fennella02]

GRRRRR...go figure😉

[baba]

I have read somewhere that it is important to stick to the same brand of MMF, not swap between brands. I had saved a link but unfortunately can't find it, sorry.

[Wendy39 in reply to baba]

That's very interesting. That's my fear, changing between 3 brands over 2 months can't be good can it? Means another doctors appt to discuss it. Annoying when last GP appt was specifically about my IBS/diarrhoea and my haemorrhoid. Grrr. This was the in house doctors pharmacy too!

[Hidden]

I was told by the pharmacist that MMF was one of the few drugs that could be prescribed by brand name as it was important to have the same preparation each time. This is because the different brands aren't interchangeable as they contain differing amounts of active ingredient and so can affect the level of immunosupression.

Some areas have a written policy for this, mainly because MMF is used widely post kidney transplant to prevent rejection so steady levels of the active drug are important. I will see if I can find the link. The issue isn't about fillers.

[Hidden in reply to Hidden]

patient.info/medicine/mycop...

[Wendy39 in reply to Hidden]

Thank you, I've saved that link. Something else to sort out.

[Wendy39 in reply to Hidden]

Very interesting! I'll read now. Thank you!