Cellcept

[pharmacology888]

I understand that Myfortic is enteric coated, so that's why the patient shouldn't break or nor crush; but if Cellcept is only a prodrug(?) of Myfortic, and not enteric coated, why can't we break or chew?

thanks

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[Vitamin K]

The package insert doesn't say anything about why you couldn't crush or chew it, so maybe it's a palatability issue? Not sure on that one, but I also don't know why you'd want to crush or chew it anyway. It's available as a suspension, so what's the point?

 

[Quiksilver]

its an immunosuppressant, you crush it, you release powders into the air > not good. Thats why we make it IV as if it were a chemo. The same is true about opening up the tacrolimus capsules.

 

[IWantTheGenetic]

I made tacrolimus suspensions everyday on the countertop during one of my rotations. Now I know why all the pharmacists were excited to have an intern around to do all the compounding. Hopefully I didn't take too many years off my life.

 

[Quiksilver]

I made tacrolimus suspensions everyday on the countertop during one of my rotations. Now I know why all the pharmacists were excited to have an intern around to do all the compounding. Hopefully I didn't take too many years off my life.

its probably debatable how much actually gets released into the air. There has always been that worry about tablet powder and the like causing problems for pharmacists. What is always interesting is to see what happened to all those nurses in the 70s who didn't take the precautions that we now take with chemos and see what their ??cancer rates?? were.

on an aside, those capsules suck ass because not all the powder comes out. Drives me nuts to be all gowned up and try to open up those bad boys. Lame.

 

[bigpharmD]

The package insert doesn't say anything about why you couldn't crush or chew it, so maybe it's a palatability issue? Not sure on that one, but I also don't know why you'd want to crush or chew it anyway. It's available as a suspension, so what's the point?

THE main issue with MPAs is absorption issues. If you start chewing and breaking cellcept you may alter its absorption/lose product etc. and therefore put yourself at an increased risk for rejection. The manufacturer wants it to get to the stomach for increased absorption. Also there is a high rate of GI side effects and it is controversial as to whether this is a local or systemic side effect, but if you crush it you may increase the risk of this side effect occurring.