Drug interactions
Sirolimus + Ustekinumab
Severity: Major
Sirolimus and Ustekinumab: 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
Both drugs suppress the immune system, so combined use may raise the risk of serious bacterial, viral, fungal and opportunistic infections. Ustekinumab has not been studied extensively with transplant-level immunosuppression.
What this interaction means in plain words
Sirolimus and Ustekinumab 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; Ustekinumab belongs to Gastrointestinal Tract.
Why it happens
Additive immunosuppression through IL-12/23 blockade and mTOR inhibition of T-cell proliferation.
What to do
Avoid the combination where an alternative exists; if used, screen for tuberculosis and hepatitis beforehand and monitor closely for infection, using the lowest effective sirolimus exposure guided by trough levels.
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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab Major
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 Ustekinumab?
MediHelp rates the interaction as major. Sirolimus and Ustekinumab 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. Both drugs suppress the immune system, so combined use may raise the risk of serious bacterial, viral, fungal and opportunistic infections. Ustekinumab has not been studied extensively with transplant-level immunosuppression.
How serious is the interaction between Sirolimus and Ustekinumab?
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 an alternative exists; if used, screen for tuberculosis and hepatitis beforehand and monitor closely for infection, using the lowest effective sirolimus exposure guided by trough levels.
What other medicines interact with Ustekinumab?
MediHelp also lists interactions of Ustekinumab with, for example, Bcg vaccine live, Typhoid vaccine live, Adalimumab. The full list is on the Ustekinumab page.
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