Drug interactions
Sirolimus + Topiramate
Severity: Moderate
Sirolimus and Topiramate: 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
Topiramate may modestly reduce sirolimus exposure, which could lessen immunosuppression and raise rejection risk. The effect is expected to be small but matters given the narrow therapeutic window.
What this interaction means in plain words
Sirolimus and Topiramate 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; Topiramate belongs to Central Nervous System.
Why it happens
Weak induction of CYP3A4 by topiramate increasing sirolimus metabolism.
What to do
Check sirolimus trough levels after starting, stopping or changing the dose of topiramate, and adjust the sirolimus dose to the target range.
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 Topiramate
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 Sirolimus with Topiramate?
MediHelp rates the interaction as moderate. Sirolimus and Topiramate 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. Topiramate may modestly reduce sirolimus exposure, which could lessen immunosuppression and raise rejection risk. The effect is expected to be small but matters given the narrow therapeutic window.
How serious is the interaction between Sirolimus and Topiramate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check sirolimus trough levels after starting, stopping or changing the dose of topiramate, and adjust the sirolimus dose to the target range.
What other medicines interact with Topiramate?
MediHelp also lists interactions of Topiramate with, for example, Benzhydrocodone / acetaminophen, Buprenorphine long-acting, Buprenorphine subdermal implant. The full list is on the Topiramate page.
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