sirolimus - oral, Rapamune

BRAND NAME(S): Rapamune

Warning|Medication Uses|How To Use|Side Effects|Precautions|Drug Interactions|Overdose|Notes|Missed Dose|Storage

WARNING:Sirolimus lowers the body's ability to fight an infection/disease (immunosuppression). This may increase your risk of developing an infection or certain types ofcancer(e.g.,skin cancer,lymphoma). To reduce the risk of these serious side effects, take this medication at the lowest effective dose as directed by your doctor. Keep all medical and laboratory appointments.

Tell your doctor immediately if you develop any of the following: unusual skin changes, change in the appearance/size ofmoles, unusual growths/lumps, swollen glands,night sweats, unexplainedweight loss, signs of infection (e.g.,fever, persistentsore throat).

Sirolimus is not recommended for thepreventionof rejection ofliveror lung transplants because it has infrequently caused very serious (possibly fatal) liver/lung problems in those cases.

USES:Sirolimus is used with other medications to prevent rejection of akidney transplant．This medication belongs to a class ofdrugsknown as immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new organ as if it were your own.

HOW TO USE:Take this medication by mouth, usually once daily or as directed by your doctor. Swallow this medication whole. Do not crush, chew, or break the tablets. If you havenauseaor anupset stomach, you may take this drug with food. However, you must choose one way (with food or without food) and always take this medication the same way so that your body always absorbs the same amount of drug. Consult your doctor or pharmacist for more details.Dosage is based on your weight, medical condition, blood test results (e.g., sirolimus trough levels), and response to treatment. Do not take more than 40 milligrams in any 24-hour period.Do not increase your dose or take this medication more often without your doctor's approval. Your condition will not improve any faster and the risk of serious side effects may be increased. Also, do not stop taking this medication without your doctor's approval.Take this medication regularly in order to get the most benefit from it. It is important to take all doses on time to keep the amount of medicine in your body at a constant level. Remember to take it at the same time each day.The tablet and solution forms of this medication may deliver different amounts of medication. Do not switch between the tablet and solution forms without your doctor's permission and directions.Other medications (e.g., antibiotics, immunosuppressants) may also be prescribed to help prevent infection in your body and to help prevent rejection of the transplanted organ. Take these additional medications exactly as prescribed by your doctor.Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.Inform your doctor if your condition worsens.

SIDE EFFECTS:See also Warning section.Diarrhea,joint pain, shaking,acne, or trouble sleeping may occur. If any of these effects persist or worsen, notify your doctor promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur:muscle pain/cramps, bonepain, increasedthirst/hunger,frequent urination, vision changes,hearingproblems (e.g.,hearing loss,ringing in the ears), unusualtiredness/weakness, fast/slow/irregular heartbeat,easy bruising/bleeding, mental/mood changes, swelling ankles/feet, severeheadache,dizziness、胃/abdominal pain．Tell your doctor immediately if any of these rare but very serious side effects occur: change in the amount of urine, frothy urine,chest pain,shortness of breath,pain/redness/swelling of arms or legs,dark urine, yellowing eyes/skin, persistentnausea/vomiting．Sirolimus may slowwoundhealing after surgery. Tell your doctor immediately if you have signs that your surgery wound is not healing well (e.g., redness, swelling, pain). The risk of poor wound healing is higher if you areobese．Sirolimus may cause yourcholesterol/triglyceridesto increase. You may be required to have your cholesterol/triglycerideschecked periodically and/or take another medication to control your cholesterol/triglycerides．A very seriousallergic reactionto this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a seriousallergicreaction:rash,itching/swelling (especially of the face/tongue/throat), severedizziness, troublebreathing．Sirolimus can commonly cause a mildrashthat is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of asevere allergic reaction．因此,如果y立即寻求医护人员的帮助ou develop any rash.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS:Before taking sirolimus, tell your doctor or pharmacist if you are allergic to it; or to other macrolide medications (e.g.,tacrolimus,erythromycin); or if you have any otherallergies．Before using this medication, tell your doctor or pharmacist your medical history, especially of:liver disease,kidney disease,high cholesterol/triglyceride levels, any recent/current infections,cancer．This medication may increase your risk of developingskin cancer．Avoid prolonged sun exposure, tanning booths, and sunlamps. Use asunscreenwith a high protection factor and wear protective clothing when outdoors.Do not have immunizations/vaccinationswithout the consent of your doctor, and avoid contact with people who have recently received oralpoliovaccineorflu vaccineinhaled through the nose.Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g.,flu,chickenpox).This medication is not recommended for use duringpregnancy．Consult your doctor for more details and to discuss reliable forms ofbirth control．It is recommended that men and women using this medication use two effective forms ofbirth control(e.g.,condomsandbirth control pills) before starting this medication, while taking this medication, and for 12 weeks after stopping this medication. Consult your doctor.This drug may pass intobreast milkand could have undesirable effects on anursinginfant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

QUESTION

The only purpose of the kidneys is to filter blood.See Answer

DRUG INTERACTIONS:See also How to Use section.Your doctor or pharmacist may already be aware of any possibledrug interactionsand 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 affectingliver enzymesthat remove sirolimus from your body (such as certain azole antifungals includingitraconazole,ketoconazole, certain钙通道阻滞剂includingnifedipine,diltiazem,verapamil大环内酯物抗生素,包括erythromycin,cimetidine,danazol,bromocriptine,nefazodone,protease inhibitorsincludingnelfinavir,ritonavir, rifamycins including rifampin,rifabutin,St. John's wort, certain anti-seizuremedicines includingcarbamazepine,phenytoin), drugs affecting the kidneys (e.g., amphotericin B, cisplatin, ganciclovir, aminoglycosides such as gentamicin),metoclopramide, tacrolimus, temsirolimus.If you are also takingcyclosporine,然后把西罗莫司cyclospor后4小时ine 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 localpoison controlcenter 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 notflushmedications 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).