Drug interactions
Sirolimus + Venetoclax
Severity: Major
Sirolimus and Venetoclax: 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
Venetoclax inhibits P-glycoprotein and may increase absorption of P-gp substrates such as sirolimus, which has a narrow therapeutic index. Elevated sirolimus concentrations can increase toxicity including cytopenias, infections, and metabolic effects.
What this interaction means in plain words
Sirolimus and Venetoclax 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; Venetoclax belongs to Miscellaneous.
Why it happens
Venetoclax inhibits intestinal P-glycoprotein efflux, increasing sirolimus bioavailability.
What to do
Avoid concomitant use where possible; if required, give sirolimus at least 6 hours before venetoclax and monitor sirolimus trough levels and blood counts.
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 Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
Frequently asked questions
Can I take Sirolimus with Venetoclax?
MediHelp rates the interaction as major. Sirolimus and Venetoclax 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. Venetoclax inhibits P-glycoprotein and may increase absorption of P-gp substrates such as sirolimus, which has a narrow therapeutic index. Elevated sirolimus concentrations can increase toxicity including cytopenias, infections, and metabolic effects.
How serious is the interaction between Sirolimus and Venetoclax?
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 concomitant use where possible; if required, give sirolimus at least 6 hours before venetoclax and monitor sirolimus trough levels and blood counts.
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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