Drug interactions
Fludrocortisone + Sirolimus
Severity: Minor
Fludrocortisone and Sirolimus: minor 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
Fludrocortisone may modestly induce CYP3A4, potentially lowering sirolimus concentrations, but the effect is weak and poorly documented. Sirolimus has a narrow therapeutic index, so subtherapeutic levels could raise rejection risk.
What this interaction means in plain words
Fludrocortisone and Sirolimus have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Fludrocortisone belongs to Endocrine; Sirolimus belongs to Miscellaneous.
Why it happens
Possible weak CYP3A4 induction by corticosteroid increasing sirolimus metabolism; not well established.
What to do
Monitor sirolimus trough concentrations when starting or stopping fludrocortisone and adjust the dose accordingly.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Fludrocortisone
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 Fludrocortisone with Sirolimus?
MediHelp rates the interaction as minor. Fludrocortisone and Sirolimus have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Fludrocortisone may modestly induce CYP3A4, potentially lowering sirolimus concentrations, but the effect is weak and poorly documented. Sirolimus has a narrow therapeutic index, so subtherapeutic levels could raise rejection risk.
How serious is the interaction between Fludrocortisone and Sirolimus?
MediHelp rates it minor, 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 starting or stopping fludrocortisone and adjust the dose accordingly.
What other medicines interact with Fludrocortisone?
MediHelp also lists interactions of Fludrocortisone with, for example, Mifepristone, Aldesleukin, Amphotericin b. The full list is on the Fludrocortisone page.
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