Drug Interaction Report

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.

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.

The recommended maximum number of medicines in the 'macrolide immunosuppressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'macrolide immunosuppressants' category:

• Fyarro (sirolimus protein-bound)
• sirolimus

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

The recommended maximum number of medicines in the 'mTOR inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'mTOR inhibitors' category:

• Fyarro (sirolimus protein-bound)
• sirolimus

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.