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sirolimus solution - oral, Rapamune (cont.)

PRECAUTIONS: Before taking sirolimus, tell your doctor or pharmacist if you are allergic to it; or to other macrolide medications (e.g., tacrolimus, erythromycin); or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, high cholesterol/triglyceride levels, any recent/current infections, cancer.This medication may increase your risk of developing skin cancer. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen with a high protection factor and wear protective clothing when outdoors.Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g., flu, chickenpox).This medication is not recommended for use during pregnancy. Consult your doctor for more details and to discuss reliable forms of birth control. It is recommended that men and women using this medication use two effective forms of birth control (e.g., condoms and birth control pills) before starting this medication, while taking this medication, and for 12 weeks after stopping this medication. Consult your doctor.This drug may pass into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also How to Use section.Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.This drug should not be used with the following medication because very serious interactions may occur: voriconazole.If you are currently using the medication listed above, tell your doctor or pharmacist before starting sirolimus.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: cisapride, drugs affecting liver enzymes that remove sirolimus from your body (such as certain azole antifungals including itraconazole, ketoconazole, certain calcium channel blockers including nifedipine, diltiazem, verapamil, macrolide antibiotics including erythromycin, cimetidine, danazol, bromocriptine, nefazodone, protease inhibitors including nelfinavir, ritonavir, rifamycins including rifampin, rifabutin, St. John's wort, certain anti-seizure medicines including carbamazepine, phenytoin), drugs affecting the kidneys (e.g., amphotericin B, cisplatin, ganciclovir, aminoglycosides such as gentamicin), metoclopramide, tacrolimus, temsirolimus.If you are also taking cyclosporine, then take sirolimus 4 hours after your cyclosporine dose. Consult your pharmacist for more information.Studies have shown when this drug is given with other specific immunosuppressants (mycophenolate, basiliximab) immediately after kidney transplant surgery, there is a greater risk of rejection. Therefore, this combination of drugs is not recommended. Discuss the details with your doctor.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.



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