Sirolimus vs CycloSPORINE

Interacting Drugs
Sirolimus
vs
CycloSPORINE
Security Level
Moderate, Consider therapy modification
Mechanism
CycloSPORINE: Sirolimus may enhance the adverse/toxic effect of CycloSPORINE. An increased risk of calcineurin inhibitor-induced hemolytic uremic syndrome/thrombotic thrombocytopenic purpura/thrombotic microangiopathy (HUS/TTP/TMA) has been described. CycloSPORINE may increase the serum concentration of Sirolimus. This is of specific concern with cyclosporine [MODIFIED].
Management
Administer oral doses of sirolimus 4 hours after doses of cyclosporine. Monitor for toxic effects of sirolimus if used with cyclosporine.

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