Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medication because very serious interactions may occur: voriconazole.

If you are currently using the medication listed above, tell your doctor or pharmacist before starting sirolimus.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: cisapride, drugs affecting liver enzymes that remove sirolimus from your body (such as certain azole antifungals including itraconazole, ketoconazole, certain calcium channel blockers including nifedipine, diltiazem, verapamil, macrolide antibiotics including erythromycin, cimetidine, danazol, bromocriptine, nefazodone, protease inhibitors including nelfinavir, ritonavir, rifamycins including rifampin, rifabutin, St. John's wort, certain anti-seizure medicines including carbamazepine, phenytoin), drugs affecting the kidneys (e.g., amphotericin B, cisplatin, ganciclovir, aminoglycosides such as gentamicin), metoclopramide, tacrolimus, temsirolimus.

If you are also taking cyclosporine, then take sirolimus 4 hours after your cyclosporine dose. Consult your pharmacist for more information.

Studies have shown when this drug is given with other specific immunosuppressants (mycophenolate, basiliximab) immediately after kidney transplant surgery, there is a greater risk of rejection. Therefore, this combination of drugs is not recommended. Discuss the details with your doctor.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents should call the US National Poison Hotline at 1-800-222-1222. Canada residents should call a provincial poison control center.

NOTES: Laboratory and/or medical tests (e.g., kidney/liver function, cholesterol/triglyceride levels, urine tests for protein, sirolimus trough level) will be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

If you have had an organ transplant, it is recommended that you attend a transplant education class or support group. Learn the signs of organ rejection such as a feeling of being ill, fever, or tenderness/pain around the transplanted organ. Tell your doctor immediately if you notice any of these signs.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised December 2010. Copyright(c) 2010 First Databank, Inc.