Drug Interaction Report

Using denosumab together with sirolimus can increase the risk of serious infections involving the skin, lower stomach area (abdomen), bladder, ear, or inner lining of the heart. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Contact your doctor immediately if you develop fever or chills; red, swollen skin or skin that is hot or tender to the touch; itching or rash; blisters; severe abdominal pain; or frequent, urgent, or painful/burning urination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Grapefruit and grapefruit juice may interact with sirolimus and could lead to potentially dangerous effects. Avoid eating grapefruit or drinking grapefruit juice while you are taking sirolimus. Also, you should preferably take sirolimus at least one hour before eating. If you do take it with food, you should take it each time with food to avoid changes in sirolimus levels. The oral liquid form of sirolimus must be mixed with water or orange juice only. Do not use grapefruit juice to mix this medication.