Drug interactions
Dexamethasone + Sirolimus
Severity: Moderate
Dexamethasone 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
Dexamethasone may lower sirolimus concentrations, risking reduced immunosuppression. Corticosteroids are often co-prescribed with sirolimus, so the effect is usually manageable with level monitoring.
What this interaction means in plain words
Dexamethasone 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.
Dexamethasone belongs to Endocrine; Sirolimus belongs to Miscellaneous.
Why it happens
Dexamethasone induces CYP3A4 and P-glycoprotein, increasing sirolimus clearance.
What to do
Monitor sirolimus trough concentrations when dexamethasone is started, changed or stopped and adjust the sirolimus dose accordingly.
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 Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
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 Dexamethasone with Sirolimus?
MediHelp rates the interaction as moderate. Dexamethasone 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. Dexamethasone may lower sirolimus concentrations, risking reduced immunosuppression. Corticosteroids are often co-prescribed with sirolimus, so the effect is usually manageable with level monitoring.
How serious is the interaction between Dexamethasone 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 when dexamethasone is started, changed or stopped and adjust the sirolimus dose accordingly.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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