Drug interactions

Conivaptan + Sirolimus

Severity: Major

Conivaptan and Sirolimus: major interaction.

Last updated 29 Oct 2026 Sources: US FDA label

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

Conivaptan can increase sirolimus exposure, raising the risk of immunosuppression-related infections and dose-dependent adverse effects. Sirolimus has a narrow therapeutic window.

Sirolimus

What this interaction means in plain words

Conivaptan and Sirolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Evidence level: Moderate

Why it happens

Conivaptan is a CYP3A4 inhibitor and reduces sirolimus metabolism.

What to do

Avoid concurrent use. If conivaptan is essential, monitor sirolimus trough levels and reduce the dose as needed.

What to ask your pharmacist

Does the benefit of taking both outweigh the risk in my case?
Do I need any blood test, ECG or other check while on both?
What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

sirolimus - FDA drug label (DailyMed) - section 7 Drug Interactions (class statement: strong CYP3A4/P-gp inhibitors; "Avoid concomitant use with strong CYP3A4/P-gp inducers or strong CYP3A4/P-gp inhibitors that decrease or increase sirolimus concentrations") — DailyMed (FDA label)

Adenovirus types 4 and 7 live + Sirolimus Contraindicated
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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 Conivaptan with Sirolimus?

MediHelp rates the interaction as major. Conivaptan and Sirolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Conivaptan can increase sirolimus exposure, raising the risk of immunosuppression-related infections and dose-dependent adverse effects. Sirolimus has a narrow therapeutic window.

How serious is the interaction between Conivaptan and Sirolimus?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use. If conivaptan is essential, monitor sirolimus trough levels and reduce the dose as needed.

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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