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Sirolimus

Last updated on 21/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions  |   Tips  |   Where To Buy  

GENERIC NAME: Sirolimus

ALTERNATIVE NAME: Rapamycin

CHINESE NAME: 西羅莫司, 雷帕黴素

BRAND NAME(S) IN HONG KONG: Rapamune 雷帕鳴

DRUG CLASS: Immunosuppressants

SUB CLASS: mTOR kinase inhibitors

USED FOR: Treatment of lymphangioleiomyomatosis, Prophylaxis and treatment of organ transplant rejections

AVAILABLE DOSAGE FORMS:
– 0.5 mg, 1 mg (tablets)

What is Sirolimus for?

Sirolimus is an immunosuppressant inhibiting a regulatory kinase mTOR to lower the activity of T-lymphocytes and hence the immune system. Sirolimus is used for treatment of lymphangioleiomyomatosis and prophylaxis and treatment of organ transplant rejections.

How to use it?

Sirolimus is administered as oral tablets in Hong Kong. It should not be split, chewed or crushed. It does not differ much whether it is taken with or without food. When it is used for kidney transplant, it should be used 4 hours after oral Cyclosporin. Listed below are the indications and the dosages.

Lymphangioleiomyomatosis
Adult and elderly
The initial dose is 2 mg once daily. Adjust dose to maintain a target concentration of 5-15 ng/mL by obtaining the trough concentration after 10-20 days.

Prophylaxis of rejection in kidney transplant
Administered with Cyclosporin and corticosteroids.
Adult and elderly
Low to moderate immunological risk: The loading dose is 6 mg on day 1 after transplantation. The maintenance dose is 2 mg once daily. Adjust dose to maintain a target trough concentration of 4-12 ng/mL with the Cyclosporin and corticosteroids dose tapered down. After 2-3 months, the concentration should become 12-20 ng/mL with Cyclosporin being stopped in 4-8 weeks.
High immunological risk: The loading dose is 15 mg on day 1 after transplantation. The maintenance dose is 5 mg once daily for a year. Dose adjusted based on body response.

Child above 13 years of age and lighter than 40 kg
The loading dose is 3 mg/m2 on day 1 after transplantation. The maintenance dose is 1 mg/m2 once daily. Dose adjusted based on body response.

What are the side effects of Sirolimus?

Common side effects of Sirolimus include peripheral oedema, hypertension, headache, acne, skin rash, high blood lipid, constipation, urinary tract infection, nemia, infection, muscle pain and increased blood creatinine.

Who should not take Sirolimus?

– People who are allergic to Sirolimus or any component of the formulation.

Pharmacist Tips:

– Do not split, chew or crush.
– When it is used for kidney transplant, it should be used 4 hours after oral Cyclosporin.

Common dosing schedule:
Sirolimus is taken once daily. It does not differ much whether you take it with or without food.

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Sirolimus may interact with:
– ACE inhibitors, e.g. Captopril, Lisinopril, Perindopril
Clozapine
– CYP3A4 inhibitors, e.g. Ketoconazole, Clarithromycin, Verapamil
– Antidiabetic agents, e.g. Metformin, Sitagliptin, Gliclazide
– CYP3A4 inducers, e.g. Phenytoin, Phenobarbital, Rifampicin

Sirolimus may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Sirolimus in Hong Kong?

In Hong Kong, Sirolimus is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk

Need more information?

For detailed information about the use of Sirolimus in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.