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Sirolimus, known by the brand name Rapamune, is an immunosuppressive medication that can reduce your body's ability to fight infections and diseases. This may increase the risk of infections and certain cancers. Below are important safety warnings and precautions to consider when using sirolimus:

• Increased Cancer Risk: Long-term use can lead to skin cancer and lymphoma. Minimize sunlight exposure, wear protective clothing, and use sunblock. Keep regular medical appointments for monitoring.

• Serious Infections: The medication heightens the risk of serious bacterial, fungal, and viral infections. Avoid contact with sick individuals, practice good hygiene, and report symptoms like fever, chills, or persistent sore throat to your healthcare provider immediately.

• Liver and Lung Transplants: Sirolimus is not recommended for preventing rejection in liver and lung transplants due to rare but severe complications.

• Wound Healing: Sirolimus may delay wound healing, especially in obese individuals or those on high doses. Your healthcare team will monitor your recovery process closely.

• High Cholesterol and Triglycerides: The drug can elevate cholesterol and triglyceride levels, increasing heart disease risk. Your doctor may suggest lifestyle changes or medications to manage this.

• Drug Interactions: Sirolimus can interact with other medications, potentially leading to reduced effectiveness or increased side effects. Inform your healthcare provider about all medications you are taking.

• Kidney Health: Long-term use may impair kidney function, especially when combined with other kidney-affecting drugs. Your provider will monitor your kidney health.

• Pregnancy and Reproductive Health: Sirolimus can harm unborn babies and reduce male sperm count. Pregnancy should be avoided during treatment and for three months after discontinuation. Discuss family planning with your healthcare provider.

• Vaccinations: Avoid live vaccines while on sirolimus, as they may cause illness. Inform healthcare providers of your sirolimus use before receiving any vaccine.

In case of an overdose or adverse reaction, contact emergency services immediately. Always consult with your healthcare provider for any concerns or questions regarding the use of sirolimus.

Common side effects:

• diarrhea
• joint pain
• acne
• shaking
• trouble sleeping
• swelling in the arms and legs
• increased cholesterol and fat levels in the blood
• high blood pressure
• changes in kidney function
• constipation
• headache
• general pain
• stomach pain
• urinary tract infections

Serious side effects:

• persistent nausea or vomiting
• yellowing of the eyes or skin
• dark urine
• muscle pain or cramps
• bone pain
• increased thirst or hunger
• frequent urination
• hearing problems
• unusual tiredness
• irregular heartbeat
• easy bruising or bleeding
• mental or mood changes
• swelling of the ankles or feet
• severe headache
• dizziness
• stomach or abdominal pain
• missed or painful periods
• signs of kidney problems
• pain, redness, or swelling in the limbs
• chest pain
• shortness of breath
• symptoms of a brain infection
• serious lung issues
• severe allergic reactions
• rash

Interactions with high risk of serious adverse effects and should be avoided:

• Mifepristone
• Posaconazole
• Ritonavir
• Voriconazole
• Temsirolimus

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Adenovirus Vaccine Type 4, Live
• Adenovirus Vaccine Type 7, Live
• Bacillus of Calmette and Guerin Vaccine, Live
• Benazepril
• Clarithromycin
• Enalapril
• Itraconazole
• Ketoconazole
• Lisinopril
• Rifampin
• St John's Wort
• Tacrolimus

Interactions with low risk that usually do not require a change in therapy:

• Amprenavir
• Cyclosporine
• Diltiazem
• Erythromycin
• Rifabutin