Drug interactions
Cyclophosphamide + Sirolimus
Severity: Moderate
Cyclophosphamide 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
Cyclophosphamide and sirolimus are both immunosuppressive, so combined use can add to myelosuppression and infection risk. The legacy CYP3A4 rationale is not well established, since cyclophosphamide is mainly a CYP substrate and prodrug rather than an inhibitor.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Sirolimus belongs to Miscellaneous.
Why it happens
Additive pharmacodynamic immunosuppression and bone marrow suppression; no established pharmacokinetic effect.
What to do
Monitor complete blood counts and signs of infection during combined therapy. Adjust doses of either drug according to cytopenias and clinical status.
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 Cyclophosphamide
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 Cyclophosphamide with Sirolimus?
MediHelp rates the interaction as moderate. Cyclophosphamide 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. Cyclophosphamide and sirolimus are both immunosuppressive, so combined use can add to myelosuppression and infection risk. The legacy CYP3A4 rationale is not well established, since cyclophosphamide is mainly a CYP substrate and prodrug rather than an inhibitor.
How serious is the interaction between Cyclophosphamide 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 complete blood counts and signs of infection during combined therapy. Adjust doses of either drug according to cytopenias and clinical status.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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