Drug interactions
Rifapentine + Sirolimus
Severity: Major
Rifapentine 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
Rifapentine is a CYP3A4 inducer and can markedly reduce sirolimus exposure, risking subtherapeutic immunosuppression and rejection. The label for sirolimus advises against combining with strong inducers.
What this interaction means in plain words
Rifapentine 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.
Rifapentine belongs to Anti Bacterial; Sirolimus belongs to Miscellaneous.
Why it happens
Rifapentine induces hepatic and intestinal CYP3A4 and P-gp, increasing sirolimus clearance.
What to do
Avoid the combination where possible and consider an alternative regimen. If unavoidable, monitor sirolimus troughs frequently and adjust the dose, then readjust after rifapentine is stopped.
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
Other interactions of Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Rifapentine with Sirolimus?
MediHelp rates the interaction as major. Rifapentine 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. Rifapentine is a CYP3A4 inducer and can markedly reduce sirolimus exposure, risking subtherapeutic immunosuppression and rejection. The label for sirolimus advises against combining with strong inducers.
How serious is the interaction between Rifapentine 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: Avoid the combination where possible and consider an alternative regimen. If unavoidable, monitor sirolimus troughs frequently and adjust the dose, then readjust after rifapentine is stopped.
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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