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mycophenelate side effects

Lauren
Guest

Ernie has been tolerating 150mg of mycophenolate twice a day well. Problem is, we had to have it compounded to 150mg capsules.

We just started a small 5mg taper of his prednisolone. At the same time we were scheduled to run out of the compounded capsules, and our vet said we could try dividing the much cheaper 500mg tablets and giving 250mg in the morning and 125mg at night, for slightly more per day. He said the only potential risk was GI issues, and sure enough, Ernie now has diarrhea after being kinda constipated before. The vet said it can take up to two weeks for his body to adjust.

I am wondering if anyone has used mycophenolate, and found this to be true? It’s $60/month for the capsules vs $16/month for the tablets, so a big difference. I’m just wondering what people’s experiences with a GI adjustment has been.

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Vally
Keymaster

Bingo didn’t use this, but what if you were to do on alternate days:

Day 1 – 250mg am and 125mg pm
Day 2 – 125mg am and pm

That’s an average of 312.5 mg a day or 156.25mg per dose (over the 2 days), so closer to the dosing you’re doing now.

As I said I didn’t have to use this, you could ask you vet if there’s any problem with doing different doses over 2 days.

Vally & Bingo
xxx

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Patrice
Keymaster

Lauren,
I don’t know the half life of MMF, or what is the appropriate blood level required of the drug to be effective in dogs. Your vet may have a good idea of what is the lowest effective dose per 12 hours.

Some drugs do need to be exactly the same dose every 12 hours while some drugs have a cumulative effect that doesn’t require them to be dosed exactly the same dose every 12 hours.

Here is our AIHA Term page for more information.
https://www.secondchanceaihadogs.com/AIHA_Terms/mycophenolate-mofetil/

My thoughts, if this was my dog, would be that if I saw any of the beginnings of the serious side effects mentioned I would be very cautious because I would be worried about reaching dose related toxicity.

Because this is a human drug being used off label in veterinary medicine it’s hard to nail down exact doses for the best efficacy. Your vet has clinical experience to guide him, but each dog is a different situation.

Ask if they have had success with giving this with any particular food. Also find out if they can prescribe any additional protective drugs to avoid the serious gastrointestinal problems.

Anecdotally, many dogs do better with simple canned plain pumpkin added to the diet whether its diarrhea or constipation. And I can certainly recommend that now.

Again, if this were me, I would go lower in the dose specifically to avoid these problems. But you can’t take my word for this.
My best Patrice

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