Drug interactions
Cimetidine + Sirolimus
Severity: Moderate
Cimetidine 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
Cimetidine may increase sirolimus blood concentrations, raising the risk of hyperlipidemia, cytopenias and impaired wound healing. Sirolimus has a narrow therapeutic window.
What this interaction means in plain words
Cimetidine 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.
Cimetidine belongs to Gastrointestinal Tract; Sirolimus belongs to Miscellaneous.
Why it happens
Cimetidine inhibits CYP3A4 and P-glycoprotein, reducing sirolimus clearance.
What to do
Monitor sirolimus trough levels when cimetidine is started or stopped and adjust the dose accordingly. Consider famotidine.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
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
Frequently asked questions
Can I take Cimetidine with Sirolimus?
MediHelp rates the interaction as moderate. Cimetidine 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. Cimetidine may increase sirolimus blood concentrations, raising the risk of hyperlipidemia, cytopenias and impaired wound healing. Sirolimus has a narrow therapeutic window.
How serious is the interaction between Cimetidine 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 levels when cimetidine is started or stopped and adjust the dose accordingly. Consider famotidine.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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