Mycophenolate Mofetil (MMF)
What is it?
Mycophenolate mofetil (‘mycophenolate’) is known as an immunosuppressant as it dampens the immune response. It is taken to prevent organ rejection in people who have received a transplant and is also used to treat autoimmune diseases such as psoriasis and lupus.
Benefits
What are the benefits of using mycophenolate in pregnancy?
Mycophenolate helps to stop your body rejecting a transplanted organ and improves symptoms in those with lupus and some skin conditions. It is only used in pregnancy in rare cases where a doctor believes that switching from this drug may lead to rejection of a transplanted organ.
Risks
What are the risks of using mycophenolate in pregnancy?
Mycophenolate can cause miscarriage and severe birth defects in the baby. These include ear, eye and other facial defects, heart malformations, problems with the diaphragm and oesophagus (gullet), and spinal and bone defects.
Women who are taking mycophenolate and at risk of becoming pregnant should use at least one form of reliable contraception during treatment and for six weeks after stopping.
Women who accidentally conceive while taking mycophenolate should contact their doctor or specialist urgently so that their medication can be reviewed.
Alternatives
Are there any alternatives to using mycophenolate in pregnancy
Yes, in most cases other medicines can be used in pregnancy to prevent rejection of a transplanted organ or to control autoimmune disease.
Women taking mycophenolate who are planning a pregnancy should talk to their specialist about other treatment options.
If your doctor has suggested that you continue to take mycophenolate during pregnancy, this is because they think that there is a high risk of transplant rejection if your medicine is changed. Your doctor will talk with you about the risks to your baby posed by continuing mycophenolate treatment during pregnancy.
No treatment
What if I prefer not to take medicines during pregnancy?
Your doctor will only prescribe medicines when necessary and will be happy to talk with you about any concerns that you might have. In women with transplants for whom mycophenolate treatment is stopped, it is very important that alternative anti-rejection drugs are taken during pregnancy. Alternative drug treatment may also be required in women who previously took mycophenolate for lupus or severe psoriasis to ensure that their condition is as well-controlled as possible and to avoid complications.
Will my baby need extra monitoring?
As part of routine antenatal care, most women will be offered a very detailed scan at around 20 weeks of pregnancy to check the baby’s development. Women who have taken mycophenolate in early pregnancy may be offered more focussed scanning on the areas of the baby’s body that can be affected by mycophenolate exposure, and may be offered additional checks of the baby’s wellbeing.
Are there any risks to my baby if the father has used mycophenolate?
There is currently no evidence that mycophenolate used by the father can harm the baby through effects on the sperm. However, as a precaution, the manufacturer recommends that where the male partner is taking mycophenolate, pregnancy should be avoided during treatment and for three months after the drug is stopped. When a pregnancy is being planned and the male partner takes mycophenolate, he should speak to his specialist about whether changing medication is the best option.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.