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| Drug class description : | Immuno-suppressant |
| Generic Name : | Sirolimus |
| Drug description : | 1 mg/ml - 60 ml bottle, 1 mg/ml - 30 x 1ml sachets, 2 mg/2ml - 30 x 2 ml sachets. |
| Presentation : | Sirolimus 1 mg per ml; oral solution. |
| Indications : | To prevent organ rejection in renal transplant patients at low to moderate immunological risk. Initially in combination with cyclosporin microemulsion and corticosreriods for 2 to 3 months. Maintenance therapy may be continued with corticosteroids only if cyclosporin can be progressively discontinued. |
| Adult Dosage : | Initially 6 mg loading dose as soon as possible after transplant, then 2 mg once daily for 2 - 3 months. Individualise treatment to obtain whole blood though levels of 4 to 12 nanogram/ml. Optimise therapy with tapering regimen of corticorsteriods and cyclosporin microemulsion. Maintenance, to obtain whole blood through levels of 12 to 20 nanogram/ml given with corticosteriods. Discontinue if cyclosporin cannot be withdrawn. |
| Child Dosage : | Not recommended. |
| Contra Indications : | High immunological risk. Pregnancy, ensure effective contraception during and for 12 weeks after therapy. Lactation |
| Special Precautions : | Use under specialist supervision. Heparic impairment. Monitor whole blood concentrations and renal function. Skin cancer risk, hyperlipidaemia. Black patients, elderly. |
| Interactions : | Strong inhibitors or inducers of CYP3A4, cyclosporin, drugs affecting renal function or the multidrug efflux pump P-glycoprotein. Grapefruit juice. |
| Adverse Reactions : | Lymphocele, abnormal healing, oedema, concomitant infections, tachycardia, GI upset, blood dyscrasias, metabolic or nutritional disoreers, arthralgia, bone necrosis epistaxis, pneumonia, skin reactions. UTI's pyelonephritis, pneumonitis. Increased susceptibilty to lymphoma and other malignancies. |
| Manufacturer : | Wyeth |
| Drug Availability : | (POM) |
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