Sandimmune vs. Cellcept for Organ Transplant: Important Differences and Potential Risks.

Key takeaways

Cyclosporine (Sandimmune) and mycophenolate (CellCept) are both immunosuppressants used to prevent organ rejection after a transplant, but they belong to different drug classes and work in distinct ways. Cyclosporine is a calcineurin inhibitor that lowers immune activity by inhibiting a specific enzyme, while mycophenolate is an antiproliferative that blocks the production of certain immune cells. Cyclosporine is typically taken once daily and is available in both oral and intravenous (IV) forms, whereas mycophenolate is usually taken twice daily and also comes in oral and IV forms. Cyclosporine can cause side effects like high blood pressure and kidney problems, while mycophenolate can lead to issues like high blood pressure, stomach upset, and low blood cell counts. Additionally, mycophenolate is not safe during pregnancy and requires effective birth control, whereas cyclosporine has specific dietary restrictions, such as avoiding grapefruit. Both medications require regular blood tests to monitor their levels and effectiveness.

Cyclosporine

(Sandimmune)

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Mycophenolate

(CellCept)

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Summary for Sandimmune

Prescription only

Unmodified cyclosporine (Sandimmune) belongs to a drug class called calcineurin inhibitors. It's used to prevent rejection after an organ transplant, usually along with corticosteroids. Typically, cyclosporine (Sandimmune) is taken by mouth once daily. Your provider will measure the level of cyclosporine (Sandimmune) in your blood to help determine your dose and minimize side effects. This medication is available as a brand-name version and lower-cost generic.

Indications for Sandimmune

Prevention of heart, liver, and kidney transplant rejection
Treatment of chronic (long-term) rejection in heart, liver, and kidney transplant recipients previously treated with other immunosuppressive medications

Pros and Cons for Sandimmune

Pros

Comes as a capsule, injection, and oral solution
Has been used safely in children age 6 months and older
Available as a lower-cost generic medication

Cons

Can raise blood pressure and blood sugar
Need to have regular lab draws to make sure this medication's levels are within a safe range
Interacts with grapefruit juice and a lot of medications

Common Side Effects for Sandimmune

Tremor (21-55%)
High blood pressure (13-53%)
Hair growth on face, chest, and back in females (21-45%)
Kidney problems (25-38%)

Warnings for Sandimmune

Medication absorption
Kidney damage
Liver problems
Possible risk of cancer
Serious infections
Side effects affecting brain function, nerves, and movement
High blood pressure
Vaccines

Summary for Cellcept

Prescription only

Mycophenolate (CellCept) belongs to a drug class called antiproliferatives and works as an immunosuppressant, meaning that it weakens your immune system. This medication is used in adults and children ages 3 months and older to help prevent their body from rejecting a transplanted organ. Mycophenolate (CellCept) is either taken by mouth or given as an infusion through the veins (IV). There are many potential side effects, including pain, headache, dizziness, and changes in blood pressure.

Indications for Cellcept

Prevention of kidney, heart, or liver transplant rejection in people ages 3 months and older; taken with other anti-rejection medications

Pros and Cons for Cellcept

Pros

Works well to prevent organ rejection
Available as an oral liquid for those who have a hard time swallowing pills
Available as an IV injection for people having trouble taking the medication by mouth
Comes as a lower-cost generic

Cons

Typically taken twice per day
Can have a lot of side effects (e.g., stomach upset, low blood cell counts, dizziness, changes in sleep, changes in blood pressure)
Not safe to take during pregnancy
Vaccines might not work as well to protect you from infection or be safe for you when you're taking mycophenolate (CellCept)

Common Side Effects for Cellcept

Muscle, neck, or back pain (79%)
High blood pressure (79%)
Swelling (68%)
Headache (59%)
Fever (56%)
Nausea (56%)
Diarrhea (53%)
Weakness (49%)
High blood sugar (48%)
High cholesterol (46%)
Shortness of breath (44%)
Constipation (44%)
Difficulty sleeping (43%)
Stomach pain (42%)
Cough (41%)
Vomiting (39%)
Dizziness (34%)
Low blood pressure (34%)
Low blood potassium levels (33%)
Viral infections (31%)

Warnings for Cellcept

Not safe during pregnancy
Possible risk of cancer
Serious infections
Low blood cell counts
Stomach bleeding and ulcers
Avoid in people with a genetic condition called hypoxanthine-guanine phosphoribosyl-transferase (HGPRT) deficiency
Inflammation in the body
Must be careful when driving
Caution use in people with phenylketonuria (PKU) - oral suspension only