Drug Interaction Report

Using denosumab together with sirolimus protein-bound 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 juice may increase the blood levels of sirolimus protein-bound. However, this has not been studied, and it is not known to what extent grapefruit juice may interact with sirolimus protein-bound. High blood levels of sirolimus protein-bound can increase side effects such as mouth sores and inflammation, nausea, diarrhea, vomiting, abdominal pain, decreased appetite, increased blood sugar, rash, hair loss, lung or breathing problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. The manufacturer recommends avoiding grapefruit and grapefruit juice during treatment with sirolimus protein-bound. Talk to your doctor if you have any questions or concerns. 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.