Sirolimus to prevent organ rejection
Rapamune
Revisione paritaria di Sid DajaniUltimo aggiornamento di Michael Stewart, MRPharmSUltimo aggiornamento 7 Ago 2023
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Sirolimus will be prescribed for you by a specialist doctor.
It is usual to take sirolimus once daily.
It is important that you take all your doses in the same way with respect to mealtimes. So, always take your doses before a meal, or always take your doses after a meal.
A colpo d'occhio
Sirolimus is a medicine used to prevent organ rejection after a kidney transplant.
It works by suppressing your body's immune system.
Take sirolimus once daily, consistently with or without food.
Do not drink grapefruit juice while taking this medicine.
Avoid immunisations and strong sunlight while on sirolimus.
Common side-effects include headache, stomach upset, and skin problems.
About sirolimus
Tipo di medicinale | Un immunosoppressore |
Utilizzato per | To prevent organ rejection following a kidney transplant operation |
Chiamato anche | Rapamune® |
Disponibile come | Tablets and oral solution |
Your body can try to reject new donor tissue following organ transplants. Sirolimus helps to prevent this by suppressing your body's immune or defence system.
Your body produces white blood cells called lymphocytes to fight infection or foreign substances which have entered the body. Following a kidney transplant, your body's immune system recognises the new organ as 'foreign' to you and will try to attack it with certain lymphocytes. Sirolimus works by preventing the activation of these lymphocytes and this helps prevent rejection of the transplanted kidney.
Before taking sirolimus
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking sirolimus it is important that your doctor knows:
Se sei incinta, stai cercando di avere un bambino o stai allattando.
Se hai problemi con il funzionamento del tuo fegato.
Se hai un'infezione o se ti è stato detto che hai il cancro.
Se hai mai avuto una reazione allergica a un medicinale.
Se stai assumendo altri medicinali. Questo include qualsiasi medicinale che stai assumendo e che è disponibile per l'acquisto senza prescrizione medica, così come i medicinali a base di erbe e complementari.
How to take sirolimus
Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about sirolimus and will provide you with a full list of side-effects which you may experience from taking it.
Your doctor will prescribe a dose which is tailored to you - it will depend upon the results of your blood tests. It is usual to take sirolimus once daily. Your doctor will tell you what time of day to take your dose, as this could depend upon other medicines you are taking. For example, if you are also taking a medicine called ciclosporin, you will be asked to take your dose of sirolimus four hours after taking ciclosporin. The dose will be printed on the label of the pack to remind you what the doctor said - make sure you take it exactly as you have been told.
Although it is not important whether you take your doses before or after food, it is important that you take all your doses in the same way with respect to mealtimes. This is because food can affect how much of the medicine gets into your bloodstream. So, always take sirolimus before a meal, oppure always take your doses after a meal.
Ingoia le compresse intere con un bicchiere d'acqua.
If you have been given the oral solution, measure out your dose using a dose syringe provided and then add it into a glass of water or orange juice. You should add it to at least 60 ml of water/orange juice. Make sure you drink all of it, and then add a further 120 ml of water/juice to your glass and drink this too so that you get the full dose. Do not mix it with any drinks other than water or orange juice. If you are unsure about how to measure out your dose using the dosing syringe, ask a doctor or pharmacist to show you.
If you forget to take a dose at your usual time, take it as soon as you can (but remember about always taking sirolimus before a meal or always taking it after a meal, and taking it four hours apart from a dose of ciclosporin). If when you remember, your next dose is almost due then take the dose that is due but leave out the forgotten dose. Do not take two doses together to make up for a missed one.
Your doctor will tell you how long your treatment is expected to continue. Keep taking sirolimus until your doctor tells you otherwise.
Ottenere il massimo dal tuo trattamento
Do not drink grapefruit juice while you are on sirolimus. This is because a chemical in grapefruit juice increases the amount of sirolimus in your bloodstream. This makes side-effects more likely.
Try to keep your regular appointments with your doctor. Your doctor will want you to have blood and urine tests during this treatment to check on your progress.
While you are taking sirolimus, and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking with your doctor first. Sirolimus lowers your body's resistance and there is a risk that you may get an infection from the vaccine. Also, some vaccines can be less effective.
Your doctor will have discussed with you the possibility of a slightly increased risk of cancer (particularly skin cancer) associated with immunosuppressants like sirolimus. Do not use sunbeds, and avoid strong sunlight or use a sun cream with a high sun protection factor (SPF of at least 15).
If you buy any medicines or herbal remedies, check with your doctor or a pharmacist that they are suitable for you to take.
If you have diabetes mellitus this medicine may affect your blood sugar levels. Test your blood regularly and report any extreme changes to your doctor.
You should avoid becoming pregnant while you are taking sirolimus and for at least 12 weeks after stopping it. Make sure you have discussed with your doctor which types of contraception are suitable for you and your partner.
If you are having an operation or any dental treatment, tell the person carrying out the treatment that you are taking an immunosuppressive medicine.
Can sirolimus cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with sirolimus. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common sirolimus side-effects (some of these can affect more than 1 in 10 people) | Cosa posso fare se sperimento questo? |
Headache, aches and pains | Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the aches continue, let your doctor know |
Stomach upset (feeling sick (nausea), constipation, diarrhoea) | Attieniti a pasti semplici - evita cibi piccanti |
Skin problems, swollen feet or ankles, menstrual problems, sore mouth, nosebleeds, fast heartbeat, being prone to infections | Se uno di questi diventa problematico, discutine con il tuo medico |
Changes to blood test results | Il tuo medico monitorerà questi aspetti |
Se si verificano altri sintomi che ritieni possano essere dovuti al medicinale, parla con il tuo medico o farmacista per ulteriori consigli.
How to store sirolimus
Tenere tutti i medicinali fuori dalla portata e dalla vista dei bambini.
Store tablets in a cool, dry place, away from direct heat and light.
Store Rapamune® Oral Solution in the fridge. Once a bottle has been opened it will keep for 30 days in a fridge - after this time, make sure you have a fresh supply. If necessary, you can leave the solution out of the fridge for a short period of time - but this should be no longer than 24 hours.
Informazioni importanti su tutti i medicinali
Informazioni importanti su tutti i medicinali
Non assumere mai più della dose prescritta. Se sospetti che tu o qualcun altro possa aver assunto un sovradosaggio di questo medicinale, recati al pronto soccorso del tuo ospedale locale. Porta con te il contenitore, anche se è vuoto.
Questo medicinale è per te. Non darlo mai ad altre persone, anche se la loro condizione sembra essere la stessa della tua.
Non conservare medicinali scaduti o indesiderati. Portali alla tua farmacia locale che li smaltirà per te.
Se hai domande su questo medicinale, chiedi al tuo farmacista.
Segnala effetti collaterali di un medicinale o vaccino
Se si verificano effetti collaterali, è possibile segnalarli online tramite il Sito web Yellow Card.

Non sei sicuro di mescolare i medicinali?
Controlla le possibili interazioni tra farmaci, integratori e alimenti prima di assumerli insieme.
Domande frequenti
Why is sirolimus prescribed specifically after a kidney transplant?
Sirolimus is an immunosuppressant medicine. After a kidney transplant, your body's immune system naturally recognises the new organ as 'foreign' and tries to attack it. Sirolimus works by preventing the activation of specific white blood cells, called lymphocytes, which are responsible for this attack, thereby helping to prevent the rejection of the transplanted kidney.
Are there any specific dietary restrictions or things I should avoid while taking sirolimus?
Yes, it is crucial to avoid drinking grapefruit juice while taking sirolimus. Grapefruit juice can increase the amount of sirolimus in your bloodstream, which makes you more likely to experience side-effects. Apart from that, ensure you consistently take sirolimus either always before a meal or always after a meal, as food affects how the medicine is absorbed.
What should I do if I have diabetes and am prescribed sirolimus?
If you have diabetes, sirolimus may affect your blood sugar levels. It's important to test your blood regularly and report any significant changes in your blood sugar to your doctor so they can adjust your treatment if necessary.
Why is there a slightly increased risk of cancer, especially skin cancer, with sirolimus?
Sirolimus is an immunosuppressant, meaning it lowers your body's immune system. Immunosuppressants are associated with a slightly increased risk of certain cancers, particularly skin cancer. To help mitigate this, you should avoid using sunbeds, strong sunlight, and always use a high-factor sun cream (at least SPF 15).
How long will I need to take sirolimus after my kidney transplant?
Your doctor will inform you how long you are expected to continue treatment with sirolimus. It's important to keep taking the medicine until your doctor tells you otherwise, as stopping it prematurely could put your transplanted kidney at risk of rejection.
Ulteriori letture e riferimenti
- Manufacturer's PIL, Rapamune® 0.5 mg, 1 mg and 2 mg coated tablets; Pfizer Limited, The electronic Medicines Compendium. Dated July 2021.
- Manufacturer's PIL, Rapamune® 1 mg/ml Oral Solution; Pfizer Limited, The electronic Medicines Compendium. Dated November 2021.
- Medicinali Completi BNF 89ª Edizione; Associazione Medica Britannica e Società Farmaceutica Reale di Gran Bretagna, Londra.
Informazioni sull'autoreVisualizza il profilo completo

Michael Stewart, MRPharmS
Responsabile Revisione Foglietti Illustrativi – Contrattista, Farmacista
BPharm (Hons), MRPharmS
Michael è un farmacista comunitario che esercita nelle Midlands e nel South Yorkshire con oltre 20 anni di esperienza nel consigliare su farmaci e condizioni mediche. Ha una solida esperienza nella formazione sanitaria, avendo prodotto e tenuto corsi di formazione per team di farmacia e personale di strutture di assistenza residenziale, inclusi infermieri. Ha anche contribuito a consigli consultivi farmaceutici per la gestione di condizioni a bassa gravità nella comunità.
Informazioni sul recensore

Sid Dajani
Sultan Dajani si è laureato alla London School of Pharmacy nel 1994 ed è diventato il più giovane membro eletto del consiglio della Royal Pharmaceutical Society dalla sua fondazione nel 1842.
Storia dell'articolo
Le informazioni su questa pagina sono scritte e revisionate da clinici qualificati.
Articolo disponibile anche in Inglese, Tedesco, Spagnolo, Francese, Italiano, Portoghese, Hindi, Ebraico, Arabo, and Svedese.
Prossima revisione prevista: 6 ago 2026
7 Ago 2023 | Ultima versione

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