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 medications because very serious interactions may occur: voriconazole, other drugs that weaken the immune system/increase the risk of infection (such as natalizumab, rituximab).If you are currently using any of the medications 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 boceprevir, nelfinavir, ritonavir, telaprevir, 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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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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