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.