Myfortic vs Cellcept or Mycophenolate? Share your experience

Posted by Alta Net @altabiznet, Apr 18 10:55am

Has anyone been switched from mycophenolate to Myfortic? Is it really better tolerated with the same efficacy?

Myfortic and CellCept are both immunosuppressants used to prevent organ rejection, with Myfortic designed to reduce gastrointestinal side effects through delayed-release formulation.
Key Differences
Formulation and Absorption:
CellCept (mycophenolate mofetil) is a prodrug that is rapidly converted in the body to the active metabolite, mycophenolic acid (MPA).

Myfortic (mycophenolic acid) is an enteric-coated formulation of MPA, designed to release the drug in the small intestine, which can lead to more consistent absorption and reduced gastrointestinal side effects.

Gastrointestinal Tolerability:
Myfortic is associated with less diarrhea, nausea, and abdominal discomfort compared to CellCept due to its delayed-release coating.

Patients who experience GI intolerance with CellCept may benefit from switching to Myfortic.
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Alta Net | @altabiznet | May 2 1:33pm

In reply to @sinojosvacios "@altabiznet My dysautonomia symptoms before Myfortic were that I would get extreme heart racing episodes during..." + (show)

@sinojosvacios
Post autologous stem cell transplant with chemo/radiation, I have similar dysautonomia symptoms to what you have described plus occasional swings in blood pressure that come and go in episodes. I am "hazy" in the morning as well, but Myfortic makes me more hazy, I think. So did Cellcept.
Thank you for sharing.

leslyb | @leslyb | May 3 8:05am

My Dr is not sure what disease I have, He has said "Maybe" it's Organizing pneumonia with a connetctive tissue disease. He has been pushng me to go on the Cellcept in order to reduce the amount of prednisone I am taking. My symptons since Aug 2025 are: started with a wheeze when I recline, it proceeded to get worse and had pain in my left lung with shortness of breathe , had a strain of pneumonia and humophalous influenza , went on 3 antibiotics and eliminated the 2 bugs. chest pain and breathing got worse, had a broncoscopy and blood work. Everything came out negative except dd strand dna (it was 12). Finally started 40 mg pred in Feb 2026 for 2 weeks then went to 30 mg for 54 days now on 25 mg for 2 weeks so far. My last Ctscan showed some improvement of inflammation. and I know I am getting better because I have no pain in my lung, my endurance and breathing are better. I still have a bad wheeze and dry cough. I did catch something and now on doxycyolone for 10 days. I am now on Albuterol 2 times a day 2 puffs. That helps a lot.
My Dr is concerned about the weakening of my immune symptons being on Prednisone so long , as I am, but the Cellcept scares me more. Again my questioin is, should I try the cellcept or continue with tappering on the prednisone? As the Dr is unsure of what I have, I am reluctant to change the course.

Alta Net | @altabiznet | May 3 3:46pm

In reply to @leslyb "My Dr is not sure what disease I have, He has said "Maybe" it's Organizing pneumonia..." + (show)

@leslyb

It is hard to answer your question without knowing your diagnosis. However, Cellcept, which is immunosuppressive drug, is usually better tolerated and safer long-term. Prednisone, when given long-term may cause serious issues, like osteoporosis, high blood pressure and poor healing. Doctors are trying not to keep patients on prednisone for too long.
The Patients usually stay on Cellcept for years at the dose up to 1500 mg per day. Those who develop GI toxicity (diarrhea, acid reflux), are switched to Myfortic, a similar drug, which is better tolerated. Both are prescribed to prevent organ rejection post-transplant, and in autoimmune diseases, like involving skin and lung: scleroderma, Sjogren's.

You may want to get a second opinion regarding stopping prednisone. If you see good response to prednisone and do not want to stop it before you get better, talk to your doctor as well - for how much longer can you stay on prednisone?
However, if your condition requires long-term immunosuppressive therapy, a switch to Cellcept or Myfortic may be indicated anyway. Best to talk to your doctor.

Becky, Volunteer Mentor | @becsbuddy | May 3 8:35pm

In reply to @leslyb "My Dr is not sure what disease I have, He has said "Maybe" it's Organizing pneumonia..." + (show)

@leslyb I really agree with @altabiznet and recommend having a 2nd opinion with a different doctor from a different practice.
Can I ask, what is it with cellcept that scares you?

arlenelmh | @arlenelmh | May 4 12:27am

For me it's Progressive Multifocal Leukoencepholopathy, BK virus, and cancer that scares me about taking the Cellcept I was prescribed and don't take. I'm hoping at some point I'll get therapeutic plasma exchange or CAR-T treatment.

leslyb | @leslyb | May 4 5:10am

In reply to @leslyb "My Dr is not sure what disease I have, He has said "Maybe" it's Organizing pneumonia..." + (show)

@leslyb
I have an 2nd opinion scheduled in mid June. I have been waiting 4 months to get in with someone. In the meantime My current pulmonologist is recommending cellcept.
My concern is , why change what's working, even though I do not have a firm diagnosis. Also I read side effects on cellcelpt that seem worse than prednisone. Am I correct?
I am having another CTS end of week and itf the inflammation is showing improvements I will push to tapper the pred to 20mg .
How many weeks for tappering seems to work? 2, 3 or 4? for not having a relapse of whatever I have, and getting off the prednisone.

Alta Net | @altabiznet | May 4 10:50am

In reply to @arlenelmh "For me it's Progressive Multifocal Leukoencepholopathy, BK virus, and cancer that scares me about taking the..." + (show)

@arlenelmh

CAR-T treatment is the most promising option at this time. However, it has some serious toxicities associated with it, way beyond what Cellcept is known to cause. You can research presentations from ASTCT, ASH and SRF websites. CAR-Ts in autoimmune diseases currently are only available via clinical trials. It may be another 2-3 years before any CAR-T for SSc will get approved. Need to stay on some medications until then. Cellcept is a reasonable option. If not well tolerated, then Myfortic. Both are frequently given with Rituximab infusions.

Alta Net | @altabiznet | May 4 11:02am

In reply to @leslyb "@leslyb I have an 2nd opinion scheduled in mid June. I have been waiting 4 months..." + (show)

@leslyb

Getting 2nd opinion is a good idea.
Prednisone is anti-inflammatory and immunosuppressive. I had prednisone taper down from 50 mg to 5 mg per day. It took 4 weeks, or so. Some people are staying on 5 mg of Prednisone long-term. However, long-term use is associated with bone loss, poor healing, and hypertension. Current medicine is trying to avoid LT prednisone for those reasons.
If it is working for you, it may be reasonable to stay on it until things get clear.
Cellcept is prescribed as a long-term treatment in autoimmune diseases. People are staying on it for years. Your pulmonologist is probably suspecting a chronic condition.

Becky, Volunteer Mentor | @becsbuddy | May 4 9:23pm

In reply to @arlenelmh "For me it's Progressive Multifocal Leukoencepholopathy, BK virus, and cancer that scares me about taking the..." + (show)

@arlenelmh I’ve been trying to figure out how best to help you understand the drugs you are/are not taking. I, too, took prednisone and cellcept, and, to be honest, I was very nervous!
https://www.drugs.com/compare/cellcept-vs-prednisone
This book on drugs gives you a side by side comparison that you may find helpful. You may also want to have a frank discussion with your doctor about your chances of bad reactions if you take the drugs. You can also talk with your pharmacist about the drugs. As for getting therapeutic plasma exchange or CAR-T treatment, they are only used if the other treatments fail. Please, just think about all your options.

arlenelmh | @arlenelmh | May 4 10:13pm

In reply to @becsbuddy "@arlenelmh I’ve been trying to figure out how best to help you understand the drugs you..." + (show)

I'm hoping for the day you don't need to be poisoned to get better
treatment. I have a lot of 1st hand experience performing biomedical
research.

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