Dosage form:

• Enteric coated tablets 180 mg , 360 mg

What is Mynalic used for?

• It is used to prevent organ rejection in adult patients receiving kidney transplants and in pediatric patients at least 5 years of age and older who are at least 6 months post kidney transplant. It is used together with other medicines containing ciclosporin and corticosteroids.

Important notes before taking Mynalic:

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have Lesch-Nyhan or Kelley-Seegmiller syndrome or a rare inherited deficiency of hypoxanthine-guanine phosphoribosyl-transferase (HGPRT).
• If you are taking any of these drugs: Azathioprine, cholestyramine, colesevelam , colestipol, metronidazole, or sevelamer.
• If you are taking another drug that has the same drug in it.
• If you are able to get pregnant and are not using 2 kinds of birth control.
• If you are breast-feeding or plan to breast-feed.
• Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

Important notes while taking Mynalic:

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
• If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
• The chance of skin cancer may be raised. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
• A severe brain problem called progressive multifocal leukoencephalopathy (PML) has happened with this drug. It may cause disability or can be deadly. Tell your doctor right away if you have signs like confusion, memory problems, depression, change in the way you act, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.
• Some people treated with this drug have had very bad kidney problems caused by a certain viral infection (BK virus). In people who have had a kidney transplant, BK virus infection may cause loss of the kidney. Call your doctor right away if you have signs of kidney problems like change in the amount of urine passed, difficulty or pain when passing urine, or blood in the urine.
• Hepatitis B or C testing may be done. A hepatitis B or C infection may get worse while taking this drug.
• Bleeding, holes, and ulcers in the GI (gastrointestinal) tract have happened with this drug. Sometimes, people have had to go to the hospital. Talk with the doctor.
• This drug may cause diarrhea. If you get diarrhea, talk with your doctor about ways to lower this effect. Do not stop taking this drug without talking with your doctor.
• A health problem called acute inflammatory syndrome (AIS) has happened with this drug. Sometimes, people have had to go to the hospital. Most of the time, signs happened within weeks to months after starting this drug or after a dose increase. Call your doctor right away if you have fever, joint pain or stiffness, or muscle pain.
• If you are 65 or older, use this drug with care. You could have more side effects.
• If your partner may get pregnant, you may need to protect your partner from pregnancy during treatment and for some time after your last dose. Talk with your doctor to see if you need to use birth control after your last dose.
• Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use 2 kinds of birth control while taking this drug.
• Use 2 kinds of birth control during treatment and for 6 weeks after your last dose.
• If you get pregnant while taking this drug or within 6 weeks after your last dose, call your doctor right away.

Mynalic side effects:

Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat
• Signs of high blood sugar like confusion, feeling sleepy, more thirst, more hungry, passing urine more often, flushing, fast breathing, or breath that smells like fruit
• Signs of electrolyte problems like mood changes, confusion, muscle pain or weakness, a heartbeat that does not feel normal, seizures, not hungry, or very bad upset stomach or throwing up
• Signs of high or low blood pressure like very bad headache or dizziness, passing out, or change in eyesight
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain
• Signs of skin infection like oozing, heat, swelling, redness, or pain
• Chest pain or pressure
• Fast or slow heartbeat
• A heartbeat that does not feel normal
• Feeling very tired or weak
• Any unexplained bruising or bleeding
• Throwing up blood or throw up that looks like coffee grounds
• Black, tarry, or bloody stools
• A burning, numbness, or tingling feeling that is not normal
• Muscle cramps
• Very bad belly pain
• Swelling
• Pale skin
• White patches in mouth
• Vaginal itching or discharge
• Yellow skin or eyes

Some people have had lung problems with this drug. Sometimes, this has been deadly. Call your doctor right away if you have signs of lung problems like shortness of breath or other trouble breathing, cough that is new or worse, or fever.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Back pain
• Constipation
• Headache
• Dizziness
• Stomach pain
• Diarrhea
• Gas
• Feeling tired or weak
• Shakiness
• Upset stomach
• Throwing up
• Decreased appetite
• Trouble sleeping

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it. If it is less than 2 hours until your next dose, skip the missed dose and go back to your normal time.
• Do not take two doses at the same time or extra doses.

How do I store and/or throw out this drug?

• Store at room temperature.
• Protect from light.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs.