Posaconazole
Contraindicated
Database
Markedly increased sirolimus levels
Contraindicated per label
Source: Kimi deep-research + Cla
Drug reference
Sirolimus
Immunosuppressant · Organ Transplant Rejection Prophylaxis
ImmunosuppressantOrgan Transplant Rejection Prophylaxis
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 12 →
- PosaconazoleContraindicatedDatabaseKimi deep-research + Cla
- AzolesSevereTextbookHarrison 22e · p1742
- CiprofloxacinSevereTextbookKDT 7e · p882
- LopinavirSevereTextbookKDT 7e · p882
Mechanism
Sirolimus functions as a non-calcineurin inhibiting immunosuppressant. It is used to suppress rejection in organ transplant recipients by modulating the immune response.
Indications
Prophylaxis of organ rejection in kidney allograft recipientsPrevention of transplant rejectionprophylaxis of organ transplant rejectionincorporated into stents to inhibit occlusionanticancer effects
Dosing
- Adult
- Initially 6 mg for 1 dose, to be given after surgery once wound has healed, then 2 mg once daily. To be given in combination with ciclosporin and corticosteroid for 2–3 months (sirolimus doses should be given 4 hours after ciclosporin), ciclosporin should then be withdrawn over 4–8 weeks (if not possible, sirolimus should be discontinued and an alternate immunosuppressive regimen used).…
Pharmacokinetics
Bioavailability
∼15%
Protein binding
40%
Metabolism
CYP3A
Excretion
—
Side effects
Common
Abdominal painAnaemiaArthralgiaAscitesConstipationDiabetes mellitusDiarrhoeaDyslipidaemiaElectrolyte imbalanceEmbolism and thrombosisFeverHaemolytic uraemic syndromeHaemorrhageHeadacheHealing impairedHyperglycaemiaHypertensionIncreased risk of infection (especially urinary-tract infection)LeucopeniaLymphatic vessel disorderhyperlipidemiaanemialeukopeniathrombocytopeniagi effectsmouth ulcershyperkalemia
Serious
- Increased susceptibility to lymphoma and other malignancies (particularly of the skin)
- Embolism and thrombosis
- Haemolytic uraemic syndrome
Drug interactions
Azoles
Severe
Textbook
Increased plasma levels of sirolimus.
Source: Harrison 22e · p1742
Ciprofloxacin
Severe
Textbook
Significantly altered (increased) sirolimus blood levels, requiring monitoring.
Blood level monitoring is required.
Source: KDT 7e · p882
Lopinavir
Severe
Textbook
Significantly altered (increased) sirolimus blood levels, requiring monitoring.
Blood level monitoring is required.
Source: KDT 7e · p882
Rifampin
Severe
Textbook
Significantly altered (decreased) sirolimus blood levels, requiring monitoring.
Blood level monitoring is required.
Source: KDT 7e · p882
Acyclovir
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Adalimumab
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amikacin
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amphotericin B
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Atazanavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Related guidelines
Acute kidney injury
KDIGO · Nephrology · 2012
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Infective endocarditis prevention
AHA · Cardiology / Dentistry · 2007
Chronic kidney disease — assessment and management
KDIGO · Nephrology · 2024
Hypertension in adults
ICMR · Cardiology · 2019
Other Immunosuppressant drugs
Ask House about Sirolimus
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-13 · House clinical team