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Rapamycin

Macrolide · Antiproliferative agent

Also known as Sirolimus

MacrolideAntiproliferative agent
CDSCO approvedSchedule H
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Rapamycin (sirolimus) is a hydrophobic macrolide that binds to the cytosolic immunophilin FKBP12. The resulting FKBP12-sirolimus complex then inhibits the mammalian target of rapamycin (mTOR) kinase. This inhibition leads to the suppression of cell cycle progression and also affects various signaling pathways, including those where PKB (Akt) regulates mTOR and impacts proteins like Bad, important in apoptosis.

Indications

Prevention of in-stent restenosis (in drug-eluting intravascular stents)

Pharmacokinetics

Protein binding
Binds to intracellular proteins (e.g., FKBP12)
Metabolism
Metabolized by CYP3A4

Side effects

Serious
  • Stent thrombosis (associated with drug-eluting stents, sometimes after discontinuation of antiplatelet therapy)

Related guidelines

Other Macrolide drugs

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Sources: Katzung, Nelson, Harriet Lane·Verified: 2026-05-10 · House clinical team