Drug interactions
Dengue vaccine + Sirolimus
Severity: Major
Dengue vaccine and Sirolimus: major interaction.
Last updated Sources: EMA SmPC
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
Sirolimus suppresses T-cell proliferation and may blunt the immune response to the live attenuated dengue vaccine. Vaccinated patients may have reduced protection, and a live vaccine carries a theoretical risk of vaccine-related infection in an immunosuppressed host.
What this interaction means in plain words
Dengue vaccine 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.
Why it happens
Pharmacodynamic antagonism: mTOR inhibition-mediated immunosuppression reduces vaccine immune response and impairs control of live attenuated virus.
What to do
Avoid giving the live dengue vaccine to patients on sirolimus; if vaccination is needed, defer until immunosuppression is withdrawn or reduced as advised by the transplant or specialist team. Review the vaccine labeling for immunocompromised patients.
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?
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References
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 Dengue vaccine with Sirolimus?
MediHelp rates the interaction as major. Dengue vaccine 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. Sirolimus suppresses T-cell proliferation and may blunt the immune response to the live attenuated dengue vaccine. Vaccinated patients may have reduced protection, and a live vaccine carries a theoretical risk of vaccine-related infection in an immunosuppressed host.
How serious is the interaction between Dengue vaccine 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 giving the live dengue vaccine to patients on sirolimus; if vaccination is needed, defer until immunosuppression is withdrawn or reduced as advised by the transplant or specialist team. Review the vaccine labeling for immunocompromised patients.
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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