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Sirolimus (Rapamune)

About Sirolimus

Sirolimus belongs to a group of medicines called immuno-suppressants. As the word immuno-suppressant suggests, the function of these drugs is to suppress the immune system, which is 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. All patients who have a kidney transplant need to take drugs called immuno-suppressants.

Sirolimus 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.

Taking your medicine

The tablets should be taken consistently with food or on an empty stomach at the same time each day.

You should AVOID grapefruit and grapefruit juice for one hour before taking sirolimus because it will affect the amount of sirolimus in your body.

Take the tablets as your doctor recommended, never change the dose yourself. If you do not take the sirolimus you will lose your new kidney.

If you forget to take a dose, or accidentally take an extra dose, tell your doctor. You will need to have regular blood samples taken to check that the dose of sirolimus is right for you. When you come to have a blood test do not take your morning dose until after you have had your blood taken.

Sirolimus is available in tablet form, and also as a liquid. The liquid must be kept in the fridge. If you are taking the tablets, the different strengths are NOT interchangeable i.e a 1mg tablet is not the same as 2x0.5mg tablets.

Unwanted effects

Sirolimus can cause side effects in some people. The most common side effects with sirolimus include headaches, feeling sick, rash, high cholesterol, anaemia and taking longer to heal wounds . You should inform your doctor if you suffer from any of these. Sirolimus can also cause anaemia.

You are more likely to develop infections whilst receiving immuno-suppressant therapy and any infections may be worse than normal, so you should report any signs of infection to your doctor.

Some other drugs may cause problems with sirolimus; these include erythromycin, clarithromycin, fluconazole, rifampicin and miconazole. Some herbal remedies may also cause problems for example St John’s wort. This is not a full list so be sure to check with your doctor or pharmacist before taking any other medication along with sirolimus.

You should avoid sunbathing and use a sunblock in sunny weather. You are recommended to see your doctor about regular skin checks and cervical smears for women. This is because you are more likely to develop skin or cervical cancers which may not be serious if noticed early.

Storing your medicine

Store the tablets in their original packet in a cool, dry place away from children. Only remove the capsules from the blister immediately before taking.

All tablets may cause side effects in some people. If you think that you are suffering from a side effect of one of your tablets it is important NOT to stop taking the tablet, but see your doctor who will be able to change that tablet for one which will suit you better.

Always take your tablets as directed by your doctor and only stop them on the advice of your doctor

Do not throw out any expired or unwanted medicine by flushing them down the toilet or throwing them away. Take them to your local pharmacy which will dispose of them for you.

Sirolimus is available in tablet form, and also as a liquid. The liquid must be kept in the fridge.

NKF Controlled Document No. 77: Sirolimus (Rapamune) written: 22/04/2000 last reviewed: 12/09/2016