Drug interactions
Grapefruit + Sirolimus
Severity: Moderate
Grapefruit 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
Grapefruit juice raises sirolimus blood levels and so can increase toxicity such as infection, hyperlipidemia, and cytopenias. The effect is unpredictable between patients.
What this interaction means in plain words
Grapefruit 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.
Why it happens
Furanocoumarins in grapefruit inhibit intestinal CYP3A4 and may inhibit P-glycoprotein, increasing sirolimus bioavailability.
What to do
Advise patients not to take sirolimus with or to drink grapefruit juice. Use water or another non-citrus juice for administration.
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
Frequently asked questions
Can I take Grapefruit with Sirolimus?
MediHelp rates the interaction as moderate. Grapefruit 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. Grapefruit juice raises sirolimus blood levels and so can increase toxicity such as infection, hyperlipidemia, and cytopenias. The effect is unpredictable between patients.
How serious is the interaction between Grapefruit 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: Advise patients not to take sirolimus with or to drink grapefruit juice. Use water or another non-citrus juice for administration.
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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