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Drug interactions

Sirolimus + Varicella virus vaccine live

Severity: Major

Sirolimus and Varicella virus vaccine live: 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

Live varicella vaccine can cause disseminated vaccine-strain varicella in patients taking sirolimus, and the immune response may be reduced. Live vaccines are generally avoided during immunosuppression.

What this interaction means in plain words

Sirolimus and Varicella virus vaccine live 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.

Evidence level: Moderate

Why it happens

Sirolimus impairs lymphocyte-mediated control of live attenuated virus and blunts vaccine response.

What to do

Avoid live varicella vaccine during sirolimus therapy; vaccinate before transplant when possible. Consider the recombinant non-live zoster vaccine for older patients.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Sirolimus with Varicella virus vaccine live?

MediHelp rates the interaction as major. Sirolimus and Varicella virus vaccine live 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. Live varicella vaccine can cause disseminated vaccine-strain varicella in patients taking sirolimus, and the immune response may be reduced. Live vaccines are generally avoided during immunosuppression.

How serious is the interaction between Sirolimus and Varicella virus vaccine live?

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 live varicella vaccine during sirolimus therapy; vaccinate before transplant when possible. Consider the recombinant non-live zoster vaccine for older patients.

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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