Brief Answer:
should be taken under strict medical supervision...

Detailed Answer:
Hello there,
Welcome to 'Ask A Doctor' service...

I've gone through your query and understand your concerns...

Well, Cellcept is basically Mycophenolate, which is primarily used in patients after receiving the transplant (hence the safety box is ambit extra-cautious). However, it's range of potential side effects are something which should warrant its use even in cases of bullous pemphigoid.

At the age of 82, initiating a new therapy with potent immunosuppressant medication like Mycophenolate always carries some concerns. Hence before as well as during the therapy, Complete blood count monitoring, strict infection control, routine physical, neurological and GI-check-ups should be carried out.

Now, regarding taking it under medical supervision- my suggestions would be definitely yes. However, it doesn't necessarily mean taking it in the medical facility (can be taken elsewhere i.e. private care, clinics also, provided it's being supervised by the doctors and paramedics and having diagnostic facilities).

Given the steroid induced effects, I'd like to know if Doxycycline was considered earlier or not. Doxycycline is also proven safer than Prednisolone (although it demonstrates a reduced success rate after therapy of 6 weeks), however, considering the safety level and longterm therapy window, it's still one of the safest among the list.

Please discuss these with your doctor and proceed accordingly.

Let me know if I can assist you further.

Take Care
Kind Regards

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