What Is Myfortic?

Myfortic is the brand name for mycophenolic acid (as mycophenolate sodium) in a delayed-release tablet formulation. It belongs to the class of selective immunosuppressants known as IMPDH inhibitors. Myfortic is FDA-approved for the prevention of organ rejection in adult patients who have received kidney transplants, and in pediatric patients aged 5 and older who are at least 6 months post kidney transplant. It is always used in combination with cyclosporine and corticosteroids.

Myfortic is also used off-label for conditions such as lupus nephritis, systemic lupus erythematosus (SLE), vasculitis, myasthenia gravis, autoimmune hepatitis, and certain autoimmune skin conditions like pemphigus.

How Does Myfortic Work?

Myfortic contains mycophenolic acid (MPA), which works by inhibiting inosine monophosphate dehydrogenase (IMPDH), an enzyme critical for the production of guanosine nucleotides. T-cells and B-cells — the immune cells responsible for organ rejection — depend heavily on this pathway to multiply. By blocking IMPDH, Myfortic selectively suppresses the proliferation of these lymphocytes, reducing the immune response that would otherwise attack a transplanted kidney.

The delayed-release (enteric-coated) formulation is designed to release the medication in the small intestine rather than the stomach, which may help reduce some of the gastrointestinal side effects associated with mycophenolate products.

What Doses Are Available for Myfortic?

• 180 mg delayed-release tablets
• 360 mg delayed-release tablets

The standard adult dose is 720 mg twice daily (1,440 mg total daily). Pediatric dosing (ages 5+, at least 6 months post-transplant) is based on body surface area at 400 mg/m² twice daily, up to 720 mg twice daily. Tablets must be swallowed whole — do not crush, chew, or break them.

How Hard Is It to Find Myfortic in Stock?

Myfortic (Mycophenolic Acid delayed-release) scores a 55 out of 100 on our findability scale, indicating intermittent availability issues. Brand-name Myfortic from Novartis has generally remained in stock, but generic mycophenolate sodium delayed-release tablets have experienced supply disruptions from multiple manufacturers. Patients relying on the generic may need to call several pharmacies or check availability through Medfinder to locate it in stock near them.

If you're having trouble finding Myfortic or its generic equivalent, ask your transplant team about switching between brand and generic options, or consider checking specialty pharmacies that serve transplant patients.

Who Can Prescribe Myfortic?

Myfortic carries a boxed warning stating that only physicians experienced in immunosuppressive therapy and management of organ transplant patients should prescribe it. Specialists who commonly prescribe Myfortic include:

• Transplant nephrologists — the primary prescribers for kidney transplant rejection prevention
• Transplant surgeons — often initiate therapy post-operatively
• Nephrologists — for ongoing transplant management
• Rheumatologists — for off-label use in lupus and vasculitis
• Dermatologists — for off-label use in autoimmune skin conditions
• Neurologists — for off-label use in myasthenia gravis

Is Myfortic a Controlled Substance?

No. Myfortic is not a controlled substance and has no DEA schedule. It does not carry a risk of abuse or dependence. However, it is a high-risk medication that requires close medical supervision due to its immunosuppressive effects, boxed warnings for malignancy and serious infections, and the risk of embryofetal toxicity. Prescriptions are typically managed through transplant centers or specialty pharmacies.

Common Side Effects of Myfortic

• Nausea and vomiting
• Diarrhea
• Constipation
• Low blood cell counts (anemia, leukopenia, thrombocytopenia)
• Infections (urinary tract infections, upper respiratory infections)
• Insomnia
• Headache
• Peripheral edema (swelling)
• Painful urination
• Post-surgical pain

Serious side effects include increased risk of lymphomas and skin cancers, serious or fatal infections (including progressive multifocal leukoencephalopathy), polyomavirus-associated nephropathy, GI bleeding or perforation, and embryofetal toxicity. Report any unusual symptoms to your transplant team immediately.

Alternative Medications to Myfortic

If Myfortic is unavailable, too expensive, or not well-tolerated, your transplant team may consider these alternatives:

• CellCept (Mycophenolate Mofetil) — A prodrug of mycophenolic acid with the same mechanism. Available as capsules, tablets, oral suspension, and IV. More widely available and often less expensive, though it may cause more GI side effects than enteric-coated Myfortic.
• Azathioprine (Imuran) — An older immunosuppressant that inhibits purine synthesis. Less potent than mycophenolate products but has a well-established safety profile. Used for transplant rejection and various autoimmune conditions.
• Everolimus (Zortress) — An mTOR inhibitor with a different mechanism of action. Used in combination with reduced-dose calcineurin inhibitors for kidney transplant patients.
• Belatacept (Nulojix) — A selective T-cell costimulation blocker given as an IV infusion. An option for patients who cannot tolerate calcineurin inhibitors or mycophenolate products.

Important: Never switch immunosuppressant medications on your own. All changes must be directed by your transplant team to avoid risking organ rejection.

Drug Interactions with Myfortic

Myfortic has several clinically significant drug interactions. Always inform your transplant team of all medications you take.

• Azathioprine — Do not use together; both suppress purine metabolism, greatly increasing bone marrow suppression risk.
• Live vaccines — Avoid during Myfortic therapy, as they may be ineffective and could cause infection in immunosuppressed patients.
• Cholestyramine and bile acid sequestrants — Significantly reduce mycophenolic acid levels; avoid concomitant use.
• Acyclovir, Valacyclovir, Ganciclovir, Valganciclovir — Compete for kidney excretion; levels of both drugs may increase, especially with impaired kidney function.
• Rifampin — Can reduce mycophenolic acid levels through enzyme induction.
• Antacids (magnesium/aluminum) — Reduce absorption; space doses apart.
• Proton pump inhibitors (PPIs) — May reduce mycophenolic acid exposure.
• Hormonal contraceptives — Myfortic may reduce oral contraceptive effectiveness; use additional barrier methods.

Final Thoughts on Myfortic

Myfortic is a critical immunosuppressant for kidney transplant recipients, and maintaining an uninterrupted supply is essential to preventing organ rejection. While the brand-name product from Novartis has generally remained available, generic mycophenolate sodium delayed-release tablets have experienced intermittent supply disruptions that can cause significant stress for patients.

If you're having difficulty finding Myfortic or its generic in stock, use Medfinder to search pharmacies near you. Specialty pharmacies affiliated with transplant centers may have more reliable stock. You can also explore manufacturer savings through Novartis SaveOnMyPrescription or patient assistance through the Novartis Patient Assistance Foundation if cost is a barrier.

Never skip doses or modify your immunosuppression regimen without guidance from your transplant team — the consequences of rejection far outweigh the inconvenience of finding your medication.