Drug interactions
Letermovir + Sirolimus
Severity: Moderate
Letermovir 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
Letermovir inhibits CYP3A and can raise sirolimus concentrations. Elevated levels increase the risk of sirolimus toxicity, and exposure may fall when letermovir is discontinued.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Sirolimus belongs to Miscellaneous.
Why it happens
Letermovir inhibits CYP3A4 (and transporters such as OATP1B1/3), reducing sirolimus clearance.
What to do
Monitor sirolimus trough levels frequently during letermovir and after it is stopped, and adjust the sirolimus dose accordingly.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Sirolimus?
MediHelp rates the interaction as moderate. Letermovir 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. Letermovir inhibits CYP3A and can raise sirolimus concentrations. Elevated levels increase the risk of sirolimus toxicity, and exposure may fall when letermovir is discontinued.
How serious is the interaction between Letermovir 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 frequently during letermovir and after it is stopped, and adjust the sirolimus dose accordingly.
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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