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.
References:
1.Rapamune (sirolimus) US prescribing information. Wyeth Pharmaceuticals March, 2013.
2.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. August, 2012.





