MEDICATION TYPE
Immunosuppressant
INDICATIONS
Licensed as immunosuppressive therapy in renal transplantation. Is being used in liver and lung transplant patients without license.
DRUG INTERACTIONS
Ciclosporin
Increases plasma sirolimus concentration.
Clarithromycin, Erythromycin
Increases plasma sirolimus concentration , avoid concomitant use. Erythromycin plasma concentration also elevated.
Diltiazem, Verapamil
Increases plasma sirolimus concentration, verapamil plasma concentration also elevated.
Grapefruit Juice
Increases plasma sirolimus concentration, avoid concomitant use.
Itraconazole, Yoriconazole, Ketoconazole, Miconazole
Increases plasma sirolimus concentration avoid concomitant use.
Rifampicin, Rifabutin
Reduces plasma sirolimus concentration, avoid concomitant use.
NOTES
TDM essential. Many CYP3A4 interactions.
MEDICAL WARNING
Sirolimus should only be administered under the supervision of a healthcare professional. Always verify against current BNF and your local CF protocol before prescribing.