CellCept (Mycophenolate) and Myasthenia Gravis

Editor's Note: CellCept is used off-label to treat myasthenia gravis. Talk to your doctor about the risks and benefits of this treatment.

CellCept, also known as mycophenolate mofetil, is a medication for people with immune disorders. CellCept is in a class of drugs called immunomodulating medications, among many others used to treat myasthenia gravis (MG).

The following will help outline what to expect from treatment if your physician is considering starting you on this medication.

What is CellCept?

Cellcept works in MG by suppressing the immune system. Normally, having a strong immune system is a positive factor in overall health. However, for people with MG, the immune system is overactive, leading to a variety of symptoms.

CellCept is not just used in MG. In fact, it is used for a range of autoimmune conditions such as rheumatoid arthritis, multiple sclerosis, and many others. It is also used after organ transplantation to prevent rejection of the organ. CellCept was first trialed for the treatment of MG back in 1998.¹

However, the use of CellCept in MG is still considered off-label. This means that the drug wasn’t specifically approved for use in MG, as the manufacturer of the drug didn’t test the medication for use in people with MG. Rather, we have evidence from real-world data of its benefit in this population.

What are the precautions?

Overall, CellCept is considered safer than some other immunomodulating drugs. However, it still comes equipped with various health warnings. In the United States, these precautions are referred to as “Boxed Warnings”. Some of these alerts include:²

Serious infections: Because CellCept reduces immune system function, it increases the risk of fungal, bacterial, and viral infections.

Pregnancy toxicity: Using CellCept during pregnancy can increase the risk of miscarriage and deformations of the fetus. Because of this, CellCept is not prescribed to women of childbearing age who are considering pregnancy.

Cancer: Drugs that suppress the immune system can increase the risk of cancers, especially cancers that involve the skin.

These are not all the possible precautions of CellCept. Talk to your doctor if you are experiencing anything that causes concern during your treatment.

Starting treatment

CellCept may be considered for those who don’t achieve a benefit from a drug called pyridostigmine. Sometimes, it can be used in addition to pyridostigmine.³.

The active ingredient in CellCept, mycophenolate, comes in various dosage forms: capsule, oral (by mouth) suspension, and intravenous injection.

Be aware that you may not necessarily get the CellCept brand through your pharmacy. You may have the option for the generic, mycophenolate, which considered equivalent to the brand name (CellCept).

As a pharmacist, I generally recommend that people take the generic as it is more cost-effective yet achieves the same benefit. Some people have a preference for the brand name. If you fall into that category, let your pharmacist know when dropping off your prescription.