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Are There Any Serious Side Effects To The MMF Medication?

Posted on 1 day ago

Question: Hi,

My spouse has a condition or orbital inflammation which is a non-specific.

She also has pre-diabetes with likely insulin resistance. She has been prescribed 30mg of oral Prednisone daily for about a month and then was asked to reduce this dose to 25mg per day and then add 2000mg of mycophenolate motetil (MMF) per day.

Are there any serious side effects to the MMF medication? Is it safer to use overall than steroids?

Would you have comment regarding this treatment protocol for non-specific orbital inflammation?

Thank you.

Hi,

Apologies the correct medication name is Mycophenolate Mofetil (MMF). 1000 mg was advised as the dose per day for the first week and then 2000mg per day afterwards.

Thank you.

Answered by Dr. Dr diwashish biswas (2 hours later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi ,
Prednisolone can increase blood sugar level, so need to monitor sugar levels.
MMF DOES NOT HAVE ANY SERIOUS SIDE EFFECTS IN SHORT TERM USE.
hope your query is clear now.
Thank you

Above answer was peer-reviewed by : Dr. LAKSHMI

Follow up: Dr. Dr diwashish biswas (2 days later)

Dear Dr. Biswas,

Thank you for your reply and information.

Could I please know what might be considered short term use for MMF. I think possibly the steroids might need to be continued for one year and MMF may need to be taken during this time too.

For steroids, we are monitoring and trying to contain the blood sugar levels below 10mmol/L. This is fine with 2000mg of Metformin and 80mg of Gliclizade per day (up from 40). Will trying to control blood sugar levels while on steroids treatment help to prevent long-term diabetes from developing or is it mainly addressing the sugar levels but not assisting in preventing long term diabetes? Would you usually recommend insulin injections instead of just oral medications to control blood sugar levels where there are spikes above 10mmol/L 2 hours after meals?

Look forward to your reply.

Thank you.

Answered by Dr. Dr diwashish biswas (3 days later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi ,
3 to 6 month is short term.
Steroid-induced hyperglycemia can potentially increase the risk of developing type 2 diabetes, especially in individuals with predisposing factors.

Controlling blood sugar levels during steroid therapy does not directly prevent long-term diabetes but can reduce the strain on pancreatic beta cells, which may otherwise lead to insulin resistance and permanent diabetes.
It primarily addresses the current hyperglycemia but indirectly helps in minimizing beta-cell dysfunction and preventing long-term diabetes risk.
Insulin provides more precise control of blood glucose, especially during steroid therapy
hope your query is clear now.
Thank you

Above answer was peer-reviewed by : Dr. Dr.Raju.A.T

Follow up: Dr. Dr diwashish biswas (2 days later)

Dear Dr. Biswas,

Thank you for your informative reply.

You mentioned preventing the strain on the pancreatic cells as being important longer term. I note that the medication gliclazide stimulates the pancreas produce more insulin. Does this put a strain on the pancreas and would directly injecting insulin be a better long term option generally?

Thank you.

Answered by Dr. Dr diwashish biswas (5 days later)

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi ,
Yes you understood it right.
hope your query is clear now.
Thank you

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Above answer was peer-reviewed by : Dr. Dr. Nagamani N.G