What is your approach towards initial regimen and tapering of mycophenolate in scleroderma?

I start low and go slow to avoid diarrhea and abdominal upset. I give the patient 250 mg tablets and tell them to increase as tolerated to 1000 mg PO BID. I write Cellcept 1000 mg PO BID to the pharmacy to avoid questions. I seldom increase beyond 1000 mg PO BID because it seems like pushing the dos...

My goal is to get the patient to tolerate it first, and then uptitrate to a goal dose of 2-3 g/d. 3 g if permissible for the first year (for both progressive cutaneous and/or ILD) and then reduce after gaining improvement or significant stability to 2g daily for maintenance for at least 3-4 years. T...