Sirolimus for Renal TransplantAll patients who have a kidney transplant need to take drugs called immunosuppressants. As the name immunosuppressant suggests, the function of these drugs is to suppress the immune system, the body’s natural defence system. The aim is to dampen down the immune system enough to stop it rejecting the transplant kidney while still keeping it active enough to fight infections.
Sirolimus belongs to this group of medicines. It is only available from your doctor.
You should NOT be vaccinated with some vaccines whilst receiving sirolimus. (Vaccines are injections that can be given to help prevent you from catching some diseases, for example, polio). For vaccines you can and cannot have, see the vaccine page.
Sirolimus is available in tablet form, and also as a liquid. The liquid must be kept in the fridge. Follow the printed instructions supplied with the bottle for full administration details.
Sirolimus is to be taken once a day. It can be taken with or without food as long as you always take it the same way. Do not drink grapefruit juice or eat grapefruit while you are on sirolimus, as it can increase sirolimus blood levels.
It is important that it is taken at the same time each day. On a clinic day, do not take your dose at home, but bring it with you and take it after you have had your blood test done.
For a once a day medicine like sirolimus a “missed” dose should be taken up to 12 hours before the next dose is due. If there is less than 12 hours before your next dose do not take the missed dose and take the next dose at the usual time. Never double your doses.
Because sirolimus suppresses your immune system, you may become more susceptible to infections, as with any anti-rejection drug. Report any signs of infection to your doctor (e.g. sore throat or temperature).
The side effects that have been seen with sirolimus include stomach upsets (diarrhoea, stomach cramps, sickness, loss of appetite), headache, nose bleeds and sore mouth. Changes in blood test results have also occurred. These include a possible increase in blood levels of fat (cholesterol and triglycerides). This can be treated with a tablet in order to lower levels.
Changes in liver function tests (enzymes) have also been reported. A decrease in white blood cells (the cells which help to fight infection) and a decrease in platelets (the cells which are involved in blood clotting) can occur. Your doctor will be monitoring your blood test regularly. Inform your doctor if you experience any signs of infection or bruising/bleeding.
During the time you are taking sirolimus, and for three months afterwards, you must not become pregnant or father a child. If you think you may be pregnant at any time, notify your doctor or nurse at once.
It is important to always check with your doctor, pharmacist or nurse about taking any other medicines whilst on sirolimus. This includes medicines that you can buy. Some herbal remedies may also cause problems, including St John’s wort, so it is always best to check with your doctor or pharmacist first.
If you take any immunosuppressant drugs, you are more likely to develop skin cancer. So it is best to AVOID sunbathing and use a total sunblock in sunny weather.
Women are also more likely to develop cervical cancer. Therefore it is recommended you see your doctor about regular skin checks and cervical smears for women. These cancers are not as serious if they are noticed early.
NKF Controlled Document No. 77, Sirolimus for Renal Transplant, written 22 April 2000. Last reviewed 10 March 2010.
The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.
The National Kidney Federation is registered in England and Wales as a Company limited by guarantee (Company No 5272349) and awarded charitable status (Charity Number 1106735). Give as You Earn contributions No. CAF GY511.
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Page created: 22 April 2000
Last updated: 27 February 2011