Drug interactions
Sirolimus + Voxelotor
Severity: Major
Sirolimus and Voxelotor: 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
Voxelotor inhibits CYP3A4 and can raise concentrations of sensitive CYP3A4 substrates such as sirolimus. This may lead to sirolimus toxicity including myelosuppression, hyperlipidemia, and infection.
What this interaction means in plain words
Sirolimus and Voxelotor 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; Voxelotor belongs to Miscellaneous.
Why it happens
Voxelotor inhibits CYP3A4, reducing sirolimus metabolism.
What to do
Avoid if possible; otherwise reduce the sirolimus dose and monitor trough concentrations and adverse effects, readjusting when voxelotor 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 Voxelotor
- Amobarbital + Voxelotor Major
- Apalutamide + Voxelotor Major
- Carbamazepine + Voxelotor Major
- Cyclosporin + Voxelotor Major
- Efavirenz + Voxelotor Major
- Enzalutamide + Voxelotor Major
Frequently asked questions
Can I take Sirolimus with Voxelotor?
MediHelp rates the interaction as major. Sirolimus and Voxelotor 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. Voxelotor inhibits CYP3A4 and can raise concentrations of sensitive CYP3A4 substrates such as sirolimus. This may lead to sirolimus toxicity including myelosuppression, hyperlipidemia, and infection.
How serious is the interaction between Sirolimus and Voxelotor?
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 if possible; otherwise reduce the sirolimus dose and monitor trough concentrations and adverse effects, readjusting when voxelotor 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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