Drug interactions
Isoniazid + Sirolimus
Severity: Moderate
Isoniazid 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
Sirolimus is a CYP3A4 and P-glycoprotein substrate with a narrow therapeutic range. Isoniazid may increase sirolimus concentrations, raising the risk of hyperlipidemia, cytopenias, impaired wound healing and infection. Isoniazid is a weaker inhibitor than classic strong inhibitors, but rifamycin-containing regimens often given alongside it work in the opposite direction.
What this interaction means in plain words
Isoniazid 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.
Isoniazid belongs to Anti Bacterial; Sirolimus belongs to Miscellaneous.
Why it happens
Isoniazid inhibits CYP3A4, which may reduce sirolimus metabolism.
What to do
Measure sirolimus trough concentrations after starting or stopping isoniazid and adjust the dose accordingly. Watch for toxicity such as cytopenias and lipid abnormalities.
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 Isoniazid
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 Isoniazid with Sirolimus?
MediHelp rates the interaction as moderate. Isoniazid 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. Sirolimus is a CYP3A4 and P-glycoprotein substrate with a narrow therapeutic range. Isoniazid may increase sirolimus concentrations, raising the risk of hyperlipidemia, cytopenias, impaired wound healing and infection. Isoniazid is a weaker inhibitor than classic strong inhibitors, but rifamycin-containing regimens often given alongside it work in the opposite direction.
How serious is the interaction between Isoniazid 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: Measure sirolimus trough concentrations after starting or stopping isoniazid and adjust the dose accordingly. Watch for toxicity such as cytopenias and lipid abnormalities.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Benzhydrocodone / acetaminophen, Carbamazepine. The full list is on the Isoniazid page.
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