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Sirolimus; Tacrolimus/Grapefruit Juice Interaction

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug, changing your diet or commencing any course of treatment.

Medical warning:

Most important. A change in your diet, medicine, or dosage is likely to be necessary. Promptly consult your doctor or pharmacist.

How the interaction occurs:

Sirolimus and tacrolimus are processed by enzymes in your intestine. Grapefruit juice contains compounds that slow down this process.

What might happen:

The level of this drug can increase in your blood and may lead to increased blood pressure and damage to your kidneys.

What you should do about this interaction:

While you are taking this medicine, you should not eat grapefruit or drink grapefruit juice at any time. Do not use grapefruit juice to dilute your medicine. You may choose an alternative citrus beverage (such as orange juice). In the event that you are instructed by a healthcare professional (e.g., doctor, pharmacist, or dietitian) to eat grapefruit or drink grapefruit juice, you should immediately discuss with doctor the effects of grapefruit on the blood levels of this medicine.Contact your healthcare professional (e.g., doctor or pharmacist) for more information.Your healthcare professionals may be aware of this interaction and may be monitoring you for it. Do not start, stop, or change your medicine or diet before checking with them first.


1.Rapamune (sirolimus) US prescribing information. Wyeth Pharmaceuticals May, 2015.

2.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. September, 2013.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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