Drug interactions
Cenobamate + Sirolimus
Severity: Moderate
Cenobamate and Sirolimus: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cenobamate induces CYP3A4 and can lower sirolimus concentrations, risking inadequate immunosuppression and graft rejection. The effect may develop over days to weeks.
What this interaction means in plain words
Cenobamate and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cenobamate belongs to Central Nervous System; Sirolimus belongs to Miscellaneous.
Why it happens
Induction of CYP3A4 by cenobamate increases sirolimus metabolism.
What to do
Monitor sirolimus trough concentrations after starting or stopping cenobamate and increase the sirolimus dose as needed. Re-check levels again if cenobamate is withdrawn.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Sirolimus?
MediHelp rates the interaction as moderate. Cenobamate and Sirolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cenobamate induces CYP3A4 and can lower sirolimus concentrations, risking inadequate immunosuppression and graft rejection. The effect may develop over days to weeks.
How serious is the interaction between Cenobamate and Sirolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sirolimus trough concentrations after starting or stopping cenobamate and increase the sirolimus dose as needed. Re-check levels again if cenobamate is withdrawn.
What other medicines interact with Sirolimus?
MediHelp also lists interactions of Sirolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Sirolimus page.
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