Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of sirolimus and tacrolimus, both of which are primarily metabolized by the isoenzyme.

MANAGEMENT: Given the risk of organ rejection associated with inadequate immunosuppressant drug levels, caution is advised during concomitant therapy with CYP450 3A4 inducers. Sirolimus and tacrolimus blood levels should be checked frequently and the dosage adjusted accordingly whenever a CYP450 3A4 inducer is added to or withdrawn from therapy.

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.