Drug interactions
Istradefylline + Sirolimus
Severity: Moderate
Istradefylline 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
At 40 mg daily istradefylline raises exposure to CYP3A4 and P-gp substrates, which may raise sirolimus levels. Higher exposure can intensify sirolimus toxicity.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Sirolimus belongs to Miscellaneous.
Why it happens
Istradefylline inhibits CYP3A4 and P-glycoprotein, increasing sirolimus exposure.
What to do
Monitor sirolimus trough levels when istradefylline is started or stopped, especially at 40 mg daily, and reduce the sirolimus dose as required.
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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Sirolimus?
MediHelp rates the interaction as moderate. Istradefylline 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. At 40 mg daily istradefylline raises exposure to CYP3A4 and P-gp substrates, which may raise sirolimus levels. Higher exposure can intensify sirolimus toxicity.
How serious is the interaction between Istradefylline 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 when istradefylline is started or stopped, especially at 40 mg daily, and reduce the sirolimus dose as required.
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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