Drug interactions
Isavuconazonium + Sirolimus
Severity: Major
Isavuconazonium 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
Isavuconazole is a moderate CYP3A4 inhibitor and P-gp inhibitor, so it can increase sirolimus concentrations and the risk of toxicity. Both agents also affect infection risk through immunosuppression and the antifungal's treatment effect.
What this interaction means in plain words
Isavuconazonium 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.
Isavuconazonium belongs to Anti Fungals; Sirolimus belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by isavuconazole reduces sirolimus clearance and increases absorption.
What to do
Monitor sirolimus trough concentrations closely when isavuconazonium is started or stopped and reduce the sirolimus dose as needed.
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?
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References
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 Isavuconazonium
- Amobarbital + Isavuconazonium Contraindicated
- Apalutamide + Isavuconazonium Contraindicated
- Carbamazepine + Isavuconazonium Contraindicated
- Cisapride + Isavuconazonium Contraindicated
- Efavirenz + Isavuconazonium Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
Frequently asked questions
Can I take Isavuconazonium with Sirolimus?
MediHelp rates the interaction as major. Isavuconazonium 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. Isavuconazole is a moderate CYP3A4 inhibitor and P-gp inhibitor, so it can increase sirolimus concentrations and the risk of toxicity. Both agents also affect infection risk through immunosuppression and the antifungal's treatment effect.
How serious is the interaction between Isavuconazonium 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: Monitor sirolimus trough concentrations closely when isavuconazonium is started or stopped and reduce the sirolimus dose as needed.
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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