Drug interactions
Dronedarone + Sirolimus
Severity: Major
Dronedarone and Sirolimus: major interaction.
Last updated 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
Dronedarone can increase sirolimus blood concentrations, raising the risk of immunosuppressant toxicity such as hyperlipidemia, cytopenias, impaired wound healing and infection. Sirolimus has a narrow therapeutic range.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Sirolimus belongs to Miscellaneous.
Why it happens
Dronedarone inhibits CYP3A4 and P-glycoprotein, decreasing sirolimus metabolism and efflux.
What to do
Measure sirolimus trough concentrations when starting or stopping dronedarone and reduce the sirolimus dose as needed. Monitor for signs of toxicity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Dronedarone and Sirolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone 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 Dronedarone with Sirolimus?
MediHelp rates the interaction as major. Dronedarone 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. Dronedarone can increase sirolimus blood concentrations, raising the risk of immunosuppressant toxicity such as hyperlipidemia, cytopenias, impaired wound healing and infection. Sirolimus has a narrow therapeutic range.
How serious is the interaction between Dronedarone 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: Measure sirolimus trough concentrations when starting or stopping dronedarone and reduce the sirolimus dose as needed. Monitor for signs of toxicity.
What other medicines interact with Dronedarone?
MediHelp also lists interactions of Dronedarone with, for example, Adagrasib, Amiodarone, Arsenic trioxide. The full list is on the Dronedarone page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
