Drug interactions
Nefazodone + Sirolimus
Severity: Major
Nefazodone and Sirolimus: major 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
Nefazodone is a potent CYP3A4 inhibitor and can substantially raise sirolimus exposure. Higher levels may cause hyperlipidemia, cytopenias, impaired wound healing, infection and kidney toxicity.
What this interaction means in plain words
Nefazodone 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.
Why it happens
Inhibition of CYP3A4 (and possibly P-gp) mediated sirolimus metabolism.
What to do
Prefer an alternative antidepressant such as sertraline. If unavoidable, reduce the sirolimus dose and monitor trough concentrations closely.
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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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 Nefazodone with Sirolimus?
MediHelp rates the interaction as major. Nefazodone 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. Nefazodone is a potent CYP3A4 inhibitor and can substantially raise sirolimus exposure. Higher levels may cause hyperlipidemia, cytopenias, impaired wound healing, infection and kidney toxicity.
How serious is the interaction between Nefazodone 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: Prefer an alternative antidepressant such as sertraline. If unavoidable, reduce the sirolimus dose and monitor trough concentrations closely.
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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