Information for the public
A large review of good-quality studies looked at how well mycophenolate (given with other drugs called corticosteroids) worked at treating lupus nephritis compared with other immunosuppressant drugs (also given with corticosteroids). Lupus nephritis is a complication of systemic lupus erythematosus (or SLE for short; see What is systemic lupus erythematosus? for more information). The review found that mycophenolate worked as well as a drug called cyclophosphamide at improving symptoms and starting 'remission' (when the person has few or no symptoms). The review also found that mycophenolate was better than a drug called azathioprine for preventing flare-ups of lupus nephritis after remission.
Some other lower quality studies looked at how well mycophenolate works to treat other symptoms and complications of SLE that don't involve the kidneys. They showed that mycophenolate might work for treating SLE that affects the blood. However, it wasn't clear from the studies if it works for people with SLE affecting the skin.
What are the possible harms or side effects?
The large review found that mycophenolate had fewer harmful side effects than cyclophosphamide. These side effects included ovarian failure (when the ovaries stop working properly), problems fighting infections and hair loss. However, diarrhoea was more common in people taking mycophenolate than in those taking cyclophosphamide.
In the other studies, diarrhoea, feeling or being sick, and infections were the most common side effects. These are very common side effects of mycophenolate and can affect more than 1 in 10 people who take this medicine.
People taking mycophenolate for any condition need to have regular blood tests. When people are taking mycophenolate their body will not be as good as normal at fighting infections, so they should try and keep away from anyone who is ill. People taking mycophenolate should tell their doctor if they have any sign of infection (such as a raised temperature, sort throat or cough) or any unexplained bleeding or bruising.
People taking mycophenolate may become more sensitive to the harmful effects of sunlight, and may have an increased risk of skin cancer. They should limit the amount of sunlight they get by wearing protective clothing and using high-factor sunscreen.
It is important that women do not become pregnant while taking mycophenolate, and contraception should be used before starting treatment, during treatment, and for 6 weeks after stopping treatment. This is because mycophenolate may cause miscarriage or harm unborn babies.
Mycophenolate should not be taken by women who are breast feeding.
Please note that the results of the research studies only indicate the benefits and harms for the populations in the studies. It is not possible to predict what the benefits and harms will be for an individual patient being treated with mycophenolate.