Drug interactions
Elranatamab + Sirolimus
Severity: Moderate
Elranatamab 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
Elranatamab can cause cytokine release syndrome, during which CYP3A activity is temporarily suppressed. Sirolimus, a sensitive CYP3A4 substrate with a narrow therapeutic index, may reach higher concentrations and cause more toxicity.
What this interaction means in plain words
Elranatamab 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.
Elranatamab belongs to Oncology; Sirolimus belongs to Miscellaneous.
Why it happens
Cytokine-mediated downregulation of CYP3A4 during cytokine release syndrome reduces sirolimus clearance.
What to do
Monitor sirolimus trough levels and signs of toxicity during step-up dosing and for about two weeks after the first full dose, and during any cytokine release syndrome; reduce the sirolimus dose if levels rise.
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 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
Other interactions of Elranatamab
- Elranatamab + Ergotamine Major
- Elranatamab + Pimozide Major
- Bendamustine + Elranatamab Moderate
- Carbamazepine + Elranatamab Moderate
- Clomipramine + Elranatamab Moderate
- Clozapine + Elranatamab Moderate
Frequently asked questions
Can I take Elranatamab with Sirolimus?
MediHelp rates the interaction as moderate. Elranatamab 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. Elranatamab can cause cytokine release syndrome, during which CYP3A activity is temporarily suppressed. Sirolimus, a sensitive CYP3A4 substrate with a narrow therapeutic index, may reach higher concentrations and cause more toxicity.
How serious is the interaction between Elranatamab 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 levels and signs of toxicity during step-up dosing and for about two weeks after the first full dose, and during any cytokine release syndrome; reduce the sirolimus dose if levels rise.
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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