Drug interactions
Sirolimus + Tucatinib
Severity: Major
Sirolimus and Tucatinib: 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
Tucatinib inhibits CYP3A and can substantially raise exposure to sensitive CYP3A substrates such as sirolimus. Higher sirolimus levels increase the risk of toxicity including myelosuppression, hyperlipidemia, impaired wound healing, and infection.
What this interaction means in plain words
Sirolimus and Tucatinib 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.
Sirolimus belongs to Miscellaneous; Tucatinib belongs to Oncology.
Why it happens
Tucatinib inhibits CYP3A4-mediated metabolism of sirolimus, increasing its systemic exposure.
What to do
Avoid the combination if possible; if necessary, reduce the sirolimus dose and monitor trough concentrations closely. Re-adjust the dose after tucatinib 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 Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Sirolimus with Tucatinib?
MediHelp rates the interaction as major. Sirolimus and Tucatinib 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. Tucatinib inhibits CYP3A and can substantially raise exposure to sensitive CYP3A substrates such as sirolimus. Higher sirolimus levels increase the risk of toxicity including myelosuppression, hyperlipidemia, impaired wound healing, and infection.
How serious is the interaction between Sirolimus and Tucatinib?
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 if possible; if necessary, reduce the sirolimus dose and monitor trough concentrations closely. Re-adjust the dose after tucatinib 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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