Sirolimus
Type of Medication: Immunosuppressant
Indications: Licensed as immunosuppressive therapy in renal transplantation. Is being used in liver and lung transplant patients without license
Side Effects: lymphocele,oedema, abdominal pain, diarrhoea, tachycardia, anaemia, fever, thrombocytopenia, neutropenia, leucopenia, thrombocytopenia purpura, hyperlipidemias, increase in serun creatinine in patients also recieving ciclosporin, hypokalemia, arthralgia, acne. Less commonly venous thromboembolism, epistaxis, interstitial lung disease, impaired healing, increased risk of infection, stomatitis, haemolytic uraemia, bone necrosis, rash, pyleonephritis: rarley pancreatitis, susceptibility to lymphoma and other malignancies of the skin, pancytopenia, hepatic necrosis, hypersensitivity reactions.
Route of administration: Adult (Oral)
Dose:Refer to transplant centre for guidelines
Examples of some Drug Interactions
Interacting drug: Ciclosporin
Increases plasma sirolimus concentration.
Interacting drug: Clarithromycin, erythromycin
Increases plasma sirolimus concentration , avoid concomitant use. Erythromycin plasma concentration also elevated.
Interacting drug: Diltiazem, verapamil
Increases plasma sirolimus concentration, verapamil plasma concentration also elevated.
Interacting drug: Grapefruit juice
Increases plasma sirolimus concentration, avoid concomitant use.
Interacting drug: Itraconazole, voriconazole, ketoconazole , miconazole
Increases plasma sirolimus concentration avoid concomitant use.
Interacting drug: Rifampicin, rifabutin
Reduces plasma sirolimus concentration, avoid concomitant use.