Drug interactions
Sirolimus + Teclistamab
Severity: Moderate
Sirolimus and Teclistamab: 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
Teclistamab triggers cytokine release, which can transiently suppress CYP450 activity, particularly after the first step-up doses. Sirolimus is a CYP3A4 substrate with a narrow therapeutic range, so its blood levels may rise and toxicity may follow.
What this interaction means in plain words
Sirolimus and Teclistamab 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.
Sirolimus belongs to Miscellaneous; Teclistamab belongs to Oncology.
Why it happens
Cytokine release induced by teclistamab temporarily downregulates CYP3A4 activity and reduces sirolimus metabolism.
What to do
Monitor sirolimus trough concentrations and signs of toxicity during and after teclistamab step-up dosing and cytokine release syndrome. Adjust the sirolimus dose according to levels.
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 Teclistamab
- Pimozide + Teclistamab Major
- Carbamazepine + Teclistamab Moderate
- Colchicine + Teclistamab Moderate
- Cyclosporin + Teclistamab Moderate
- Divalproex + Teclistamab Moderate
- Ergotamine + Teclistamab Moderate
Frequently asked questions
Can I take Sirolimus with Teclistamab?
MediHelp rates the interaction as moderate. Sirolimus and Teclistamab 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. Teclistamab triggers cytokine release, which can transiently suppress CYP450 activity, particularly after the first step-up doses. Sirolimus is a CYP3A4 substrate with a narrow therapeutic range, so its blood levels may rise and toxicity may follow.
How serious is the interaction between Sirolimus and Teclistamab?
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 and signs of toxicity during and after teclistamab step-up dosing and cytokine release syndrome. Adjust the sirolimus dose according to levels.
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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