Sirolimus (Systemic)

Brand Names : rapamycin, Rapamune

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sirolimus, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to sirolimus. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Sirolimus has not been studied in pregnant women. However, studies in animals have shown that sirolimus causes problems in the fetus. It is very important that an effective form of birth control be used before starting sirolimus therapy, during sirolimus therapy, and for 12 weeks after sirolimus therapy has stopped.

Breast-feeding - It is not known whether sirolimus passes into human breast milk. However, because this medicine may cause serious side effects, breast-feeding may not be recommended while you are receiving it. Discuss with your doctor whether or not you should breast-feed while you are receiving sirolimus.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sirolimus, it is especially important that your health care professional knows if you are taking any of the following:

• Cyclosporine (e.g. Neoral or Sandimmune) or
• Diltiazem (e.g. Cardizem) or
• Ketoconazole (e.g. Nizoral) - May increase the effects of sirolimus by increasing the amount of this medicine in the body

• Rifampin (e.g. Rifadin) or
• St. John's wort - May decrease the effects of sirolimus by decreasing the amount of sirolimus in the body

• Tacrolimus (e.g. Prograf) - May cause liver transplant rejection or serious side effects in patients on sirolimus

Other medical problems - The presence of other medical problems may affect the use of sirolimus. Make sure you tell your doctor if you have any other medical problems, especially:

• Cancer or
• Hyperlipidemia (high amount of cholesterol and fats in the blood) - Sirolimus can make these conditions worse

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• Infection - Sirolimus decreases the body's ability to fight infection

• Liver disease - A lower dose of sirolimus may be needed in patients with this condition
• Liver transplantation - Sirolimus is not recommended in liver transplant patients