Drug interactions
Sarilumab + Sirolimus
Severity: Moderate
Sarilumab 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
IL-6 blockade can reverse cytokine-mediated suppression of CYP enzymes, potentially increasing metabolism of CYP3A4 substrates. Sirolimus concentrations may fall after sarilumab is started, with risk of reduced efficacy.
What this interaction means in plain words
Sarilumab 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.
Sarilumab belongs to Musculoskeletal; Sirolimus belongs to Miscellaneous.
Why it happens
IL-6 receptor blockade restores CYP3A4 expression and activity, increasing sirolimus clearance.
What to do
Monitor sirolimus trough concentrations when starting or stopping sarilumab and adjust the dose as needed.
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 Sarilumab
Frequently asked questions
Can I take Sarilumab with Sirolimus?
MediHelp rates the interaction as moderate. Sarilumab 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. IL-6 blockade can reverse cytokine-mediated suppression of CYP enzymes, potentially increasing metabolism of CYP3A4 substrates. Sirolimus concentrations may fall after sarilumab is started, with risk of reduced efficacy.
How serious is the interaction between Sarilumab 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 concentrations when starting or stopping sarilumab and adjust the dose as needed.
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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