Details of the Drug

General Information of Drug (ID: DMGW1ID)

Drug Name
Sirolimus
Synonyms
53123-88-9; Rapamune; Rapamycin (Sirolimus); AY-22989; Rapammune; sirolimusum; WY-090217; RAPA; Antibiotic AY 22989; AY 22989; UNII-W36ZG6FT64; CCRIS 9024; CHEBI:9168; SILA 9268A; W36ZG6FT64; HSDB 7284; C51H79NO13; NSC 226080; DE-109; NCGC00021305-05; DSSTox_CID_3582; DSSTox_RID_77091; DSSTox_GSID_23582; Cypher; Supralimus; Wy 090217; Perceiva; RAP; RPM; Rapamycin from Streptomyces hygroscopicus; SIIA 9268A; LCP-Siro; MS-R001; Rapamune (TN); Rapamycin (TN); Sirolimus (RAPAMUNE); Rapamycin C-7, analog 4; Sirolimus (USAN/INN); Sirolimus [USAN:BAN:INN]; Sirolimus, Rapamune,Rapamycin; Heptadecahydro-9,27-dihydroxy-3-[(1R)-2-[(1S,3R,4R)-4-hydroxy; 23,27-Epoxy-3H-pyrido(2,1-c)(1,4)oxaazacyclohentriacontine; 23,27-Epoxy-3H-pyrido[2,1-c][1,4]oxaazacyclohentriacontine; 23,27-epoxy-3H-pyrido[2,1-c][1,4]oxaazacyclohentriacontine-1,5,11,28,29; 3H-pyrido(2,1-c)(1,4)oxaazacyclohentriacontine-1,5,11,28,29(4H,6H,31H)-pentone; Sirolimus (MTOR inhibitor)
Indication
Disease Entry ICD 11 Status REF
Multiple myeloma 2A83 Approved [1], [2]
Organ transplant rejection NE84 Approved [3], [4]
Dutch elm disease 8D64 Phase 1/2 [3], [4]
Therapeutic Class
Immunosuppressive Agents
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 3 Molecular Weight (mw) 914.2
Topological Polar Surface Area (xlogp) 6
Rotatable Bond Count (rotbonds) 6
Hydrogen Bond Donor Count (hbonddonor) 3
Hydrogen Bond Acceptor Count (hbondacc) 13
Chemical Identifiers
Formula
C51H79NO13
IUPAC Name
(1R,9S,12S,15R,16E,18R,19R,21R,23S,24E,26E,28E,30S,32S,35R)-1,18-dihydroxy-12-[(2R)-1-[(1S,3R,4R)-4-hydroxy-3-methoxycyclohexyl]propan-2-yl]-19,30-dimethoxy-15,17,21,23,29,35-hexamethyl-11,36-dioxa-4-azatricyclo[30.3.1.04,9]hexatriaconta-16,24,26,28-tetraene-2,3,10,14,20-pentone
Canonical SMILES
C[C@@H]1CC[C@H]2C[C@@H](/C(=C/C=C/C=C/[C@H](C[C@H](C(=O)[C@@H]([C@@H](/C(=C/[C@H](C(=O)C[C@H](OC(=O)[C@@H]3CCCCN3C(=O)C(=O)[C@@]1(O2)O)[C@H](C)C[C@@H]4CC[C@H]([C@@H](C4)OC)O)C)/C)O)OC)C)C)/C)OC
InChI
InChI=1S/C51H79NO13/c1-30-16-12-11-13-17-31(2)42(61-8)28-38-21-19-36(7)51(60,65-38)48(57)49(58)52-23-15-14-18-39(52)50(59)64-43(33(4)26-37-20-22-40(53)44(27-37)62-9)29-41(54)32(3)25-35(6)46(56)47(63-10)45(55)34(5)24-30/h11-13,16-17,25,30,32-34,36-40,42-44,46-47,53,56,60H,14-15,18-24,26-29H2,1-10H3/b13-11+,16-12+,31-17+,35-25+/t30-,32-,33-,34-,36-,37+,38+,39+,40-,42+,43+,44-,46-,47+,51-/m1/s1
InChIKey
QFJCIRLUMZQUOT-HPLJOQBZSA-N
Cross-matching ID
PubChem CID
5284616
ChEBI ID
CHEBI:9168
CAS Number
53123-88-9
DrugBank ID
DB00877
TTD ID
D03LJR
VARIDT ID
DR00262
INTEDE ID
DR1489
ACDINA ID
D00627

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
PI3K/AKT/mTOR pathway (PAm pathway) TTGQUFK NOUNIPROTAC Inhibitor [5], [6], [7]
Serine/threonine-protein kinase mTOR (mTOR) TTCJG29 MTOR_HUMAN Inhibitor [8]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Organic anion transporting polypeptide 1B1 (SLCO1B1) DT3D8F0 SO1B1_HUMAN Substrate [9]
P-glycoprotein 1 (ABCB1) DTUGYRD MDR1_HUMAN Substrate [10]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 3A4 (CYP3A4) DE4LYSA CP3A4_HUMAN Substrate [11]
Cytochrome P450 3A5 (CYP3A5) DEIBDNY CP3A5_HUMAN Substrate [12]
Cytochrome P450 3A7 (CYP3A7) DERD86B CP3A7_HUMAN Substrate [12]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Multiple myeloma
ICD Disease Classification 2A83
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
Serine/threonine-protein kinase mTOR (mTOR) DTT MTOR 2.16E-05 -0.44 -2.3
P-glycoprotein 1 (ABCB1) DTP P-GP 2.04E-02 -1.13E+00 -1.00E+00
Organic anion transporting polypeptide 1B1 (SLCO1B1) DTP OATP1B1 6.76E-03 8.67E-02 6.17E-01
Cytochrome P450 3A5 (CYP3A5) DME CYP3A5 3.51E-02 1.53E+00 1.16E+00
Cytochrome P450 3A4 (CYP3A4) DME CYP3A4 5.84E-01 -1.61E-01 -3.61E-01
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Sirolimus
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Azathioprine DMMZSXQ Moderate Additive myelosuppressive effects by the combination of Sirolimus and Azathioprine. Transplant rejection [NE84] [58]
Coadministration of a Drug Treating the Disease Different from Sirolimus (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Remdesivir DMBFZ6L Moderate Decreased renal excretion of Sirolimus caused by Remdesivir mediated nephrotoxicity. 1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019] [58]
Metreleptin DM1NOEK Moderate Decreased metabolism of Sirolimus caused by Metreleptin mediated inhibition of CYP450 enzyme. Acute diabete complication [5A2Y] [59]
Repaglinide DM5SXUV Moderate Increased plasma concentrations of Sirolimus and Repaglinide due to competitive inhibition of the same metabolic pathway. Acute diabete complication [5A2Y] [60]
Pioglitazone DMKJ485 Moderate Increased plasma concentrations of Sirolimus and Pioglitazone due to competitive inhibition of the same metabolic pathway. Acute diabete complication [5A2Y] [60]
Ivosidenib DM8S6T7 Moderate Increased metabolism of Sirolimus caused by Ivosidenib mediated induction of CYP450 enzyme. Acute myeloid leukaemia [2A60] [58]
Midostaurin DMI6E0R Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Midostaurin. Acute myeloid leukaemia [2A60] [61]
Arn-509 DMT81LZ Major Increased metabolism of Sirolimus caused by Arn-509 mediated induction of CYP450 enzyme. Acute myeloid leukaemia [2A60] [58]
Gilteritinib DMWQ4MZ Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Gilteritinib. Acute myeloid leukaemia [2A60] [58]
Oliceridine DM6MDCF Moderate Increased plasma concentrations of Sirolimus and Oliceridine due to competitive inhibition of the same metabolic pathway. Acute pain [MG31] [60]
Framycetin DMF8DNE Major Increased risk of nephrotoxicity by the combination of Sirolimus and Framycetin. Alcoholic liver disease [DB94] [60]
Inotersen DMJ93CT Major Increased risk of nephrotoxicity by the combination of Sirolimus and Inotersen. Amyloidosis [5D00] [61]
Siltuximab DMGEATB Moderate Additive immunosuppressive effects by the combination of Sirolimus and Siltuximab. Anemia [3A00-3A9Z] [61]
Dronedarone DMA8FS5 Moderate Decreased metabolism of Sirolimus caused by Dronedarone mediated inhibition of CYP450 enzyme. Angina pectoris [BA40] [58]
Nifedipine DMSVOZT Moderate Increased plasma concentrations of Sirolimus and Nifedipine due to competitive inhibition of the same metabolic pathway. Angina pectoris [BA40] [60]
Cilostazol DMZMSCT Moderate Increased plasma concentrations of Sirolimus and Cilostazol due to competitive inhibition of the same metabolic pathway. Arterial occlusive disease [BD40] [60]
Posaconazole DMUL5EW Major Decreased metabolism of Sirolimus caused by Posaconazole mediated inhibition of CYP450 enzyme. Aspergillosis [1F20] [62]
Budesonide DMJIBAW Moderate Increased plasma concentrations of Sirolimus and Budesonide due to competitive inhibition of the same metabolic pathway. Asthma [CA23] [60]
Roflumilast DMPGHY8 Moderate Additive immunosuppressive effects by the combination of Sirolimus and Roflumilast. Asthma [CA23] [61]
Kanamycin DM2DMPO Major Increased risk of nephrotoxicity by the combination of Sirolimus and Kanamycin. Bacterial infection [1A00-1C4Z] [60]
Clarithromycin DM4M1SG Major Decreased clearance of Sirolimus due to the transporter inhibition by Clarithromycin. Bacterial infection [1A00-1C4Z] [58]
Streptomycin DME1LQN Major Increased risk of nephrotoxicity by the combination of Sirolimus and Streptomycin. Bacterial infection [1A00-1C4Z] [60]
Netilmicin DMRD1QK Major Increased risk of nephrotoxicity by the combination of Sirolimus and Netilmicin. Bacterial infection [1A00-1C4Z] [60]
Troleandomycin DMUZNIG Major Decreased clearance of Sirolimus due to the transporter inhibition by Troleandomycin. Bacterial infection [1A00-1C4Z] [58]
Telithromycin DMZ4P3A Major Decreased clearance of Sirolimus due to the transporter inhibition by Telithromycin. Bacterial infection [1A00-1C4Z] [58]
Erdafitinib DMI782S Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Erdafitinib. Bladder cancer [2C94] [63]
Etidronic acid DM1XHYJ Major Increased risk of nephrotoxicity by the combination of Sirolimus and Etidronic acid. Bone paget disease [FB85] [60]
Pexidartinib DMS2J0Z Moderate Increased metabolism of Sirolimus caused by Pexidartinib mediated induction of CYP450 enzyme. Bone/articular cartilage neoplasm [2F7B] [58]
Lapatinib DM3BH1Y Moderate Decreased metabolism of Sirolimus caused by Lapatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [64]
Exemestane DM9HPW3 Moderate Increased plasma concentrations of Sirolimus and Exemestane due to competitive inhibition of the same metabolic pathway. Breast cancer [2C60-2C6Y] [60]
Tucatinib DMBESUA Major Decreased metabolism of Sirolimus caused by Tucatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [58]
Palbociclib DMD7L94 Moderate Decreased metabolism of Sirolimus caused by Palbociclib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [58]
Letrozole DMH07Y3 Moderate Increased plasma concentrations of Sirolimus and Letrozole due to competitive inhibition of the same metabolic pathway. Breast cancer [2C60-2C6Y] [60]
Quinestrol DMJ6H1Z Moderate Increased plasma concentrations of Sirolimus and Quinestrol due to competitive inhibition of the same metabolic pathway. Breast cancer [2C60-2C6Y] [60]
Cabazitaxel DMPAZHC Moderate Increased plasma concentrations of Sirolimus and Cabazitaxel due to competitive inhibition of the same metabolic pathway. Breast cancer [2C60-2C6Y] [60]
Atorvastatin DMF28YC Moderate Increased plasma concentrations of Sirolimus and Atorvastatin due to competitive inhibition of the same metabolic pathway. Cardiovascular disease [BA00-BE2Z] [65]
Iodipamide DMXIQYS Major Increased risk of nephrotoxicity by the combination of Sirolimus and Iodipamide. Cholelithiasis [DC11] [66]
Dihydrocodeine DMB0FWL Moderate Increased plasma concentrations of Sirolimus and Dihydrocodeine due to competitive inhibition of the same metabolic pathway. Chronic pain [MG30] [60]
Ketoprofen DMRKXPT Major Increased risk of nephrotoxicity by the combination of Sirolimus and Ketoprofen. Chronic pain [MG30] [60]
Levonorgestrel DM1DP7T Moderate Increased plasma concentrations of Sirolimus and Levonorgestrel due to competitive inhibition of the same metabolic pathway. Contraceptive management [QA21] [60]
Levobupivacaine DM783CH Moderate Increased plasma concentrations of Sirolimus and Levobupivacaine due to competitive inhibition of the same metabolic pathway. Corneal disease [9A76-9A78] [60]
Halothane DM80OZ5 Moderate Increased plasma concentrations of Sirolimus and Halothane due to competitive inhibition of the same metabolic pathway. Corneal disease [9A76-9A78] [60]
Methoxyflurane DML0RAE Major Increased risk of nephrotoxicity by the combination of Sirolimus and Methoxyflurane. Corneal disease [9A76-9A78] [60]
Cocaine DMSOX7I Moderate Increased plasma concentrations of Sirolimus and Cocaine due to competitive inhibition of the same metabolic pathway. Corneal disease [9A76-9A78] [60]
Lumacaftor DMCLWDJ Major Increased metabolism of Sirolimus caused by Lumacaftor mediated induction of CYP450 enzyme. Cystic fibrosis [CA25] [58]
Ivacaftor DMZC1HS Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Ivacaftor. Cystic fibrosis [CA25] [67]
MK-8228 DMOB58Q Major Decreased metabolism of Sirolimus caused by MK-8228 mediated inhibition of CYP450 enzyme. Cytomegaloviral disease [1D82] [68]
Sertraline DM0FB1J Moderate Increased plasma concentrations of Sirolimus and Sertraline due to competitive inhibition of the same metabolic pathway. Depression [6A70-6A7Z] [60]
Cyclobenzaprine DM1YBRM Moderate Increased plasma concentrations of Sirolimus and Cyclobenzaprine due to competitive inhibition of the same metabolic pathway. Depression [6A70-6A7Z] [60]
Nefazodone DM4ZS8M Major Decreased metabolism of Sirolimus caused by Nefazodone mediated inhibition of CYP450 enzyme. Depression [6A70-6A7Z] [58]
OPC-34712 DMHG57U Moderate Increased plasma concentrations of Sirolimus and OPC-34712 due to competitive inhibition of the same metabolic pathway. Depression [6A70-6A7Z] [60]
Zonisamide DM0DTF7 Moderate Increased plasma concentrations of Sirolimus and Zonisamide due to competitive inhibition of the same metabolic pathway. Epilepsy/seizure [8A61-8A6Z] [60]
Felbamate DM1V5ZS Moderate Increased metabolism of Sirolimus caused by Felbamate mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [58]
Cenobamate DMGOVHA Moderate Increased metabolism of Sirolimus caused by Cenobamate mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [58]
Tiagabine DMKSQG0 Moderate Increased plasma concentrations of Sirolimus and Tiagabine due to competitive inhibition of the same metabolic pathway. Epilepsy/seizure [8A61-8A6Z] [60]
Stiripentol DMMSDOY Moderate Decreased metabolism of Sirolimus caused by Stiripentol mediated inhibition of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [58]
Fosphenytoin DMOX3LB Major Accelerated clearance of Sirolimus due to the transporter induction by Fosphenytoin. Epilepsy/seizure [8A61-8A6Z] [58]
Clonazepam DMTO13J Moderate Increased plasma concentrations of Sirolimus and Clonazepam due to competitive inhibition of the same metabolic pathway. Epilepsy/seizure [8A61-8A6Z] [60]
Rufinamide DMWE60C Moderate Increased metabolism of Sirolimus caused by Rufinamide mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [58]
Phenobarbital DMXZOCG Major Increased metabolism of Sirolimus caused by Phenobarbital mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [58]
Tazemetostat DMWP1BH Moderate Increased metabolism of Sirolimus caused by Tazemetostat mediated induction of CYP450 enzyme. Follicular lymphoma [2A80] [58]
Tolterodine DMSHPW8 Moderate Increased plasma concentrations of Sirolimus and Tolterodine due to competitive inhibition of the same metabolic pathway. Functional bladder disorder [GC50] [60]
Itraconazole DMCR1MV Major Decreased metabolism of Sirolimus caused by Itraconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [58]
Ketoconazole DMPZI3Q Major Decreased clearance of Sirolimus due to the transporter inhibition by Ketoconazole. Fungal infection [1F29-1F2F] [58]
Colchicine DM2POTE Moderate Increased plasma concentrations of Sirolimus and Colchicine due to competitive inhibition of the same metabolic pathway. Gout [FA25] [60]
Sulfinpyrazone DMEV954 Moderate Increased metabolism of Sirolimus caused by Sulfinpyrazone mediated induction of CYP450 enzyme. Gout [FA25] [58]
Digitoxin DMWVIGP Moderate Increased plasma concentrations of Sirolimus and Digitoxin due to competitive inhibition of the same metabolic pathway. Heart failure [BD10-BD1Z] [60]
Boceprevir DMBSHMF Major Decreased clearance of Sirolimus due to the transporter inhibition by Boceprevir. Hepatitis virus infection [1E50-1E51] [58]
Simeprevir DMLUA9D Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Simeprevir. Hepatitis virus infection [1E50-1E51] [58]
Telaprevir DMMRV29 Major Decreased metabolism of Sirolimus caused by Telaprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [58]
GS-5885 DMSL3DX Moderate Decreased clearance of Sirolimus due to the transporter inhibition by GS-5885. Hepatitis virus infection [1E50-1E51] [69]
177Lu-DOTATATE DMT8GVU Major Increased risk of nephrotoxicity by the combination of Sirolimus and 177Lu-DOTATATE. Hepatitis virus infection [1E50-1E51] [60]
Rifampin DMA8J1G Major Increased metabolism of Sirolimus caused by Rifampin mediated induction of CYP450 enzyme. HIV-infected patients with tuberculosis [1B10-1B14] [58]
Rifapentine DMCHV4I Major Accelerated clearance of Sirolimus due to the transporter induction by Rifapentine. HIV-infected patients with tuberculosis [1B10-1B14] [58]
MK-1439 DM215WE Minor Increased metabolism of Sirolimus caused by MK-1439 mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [61]
Fosamprenavir DM4W9B3 Major Decreased metabolism of Sirolimus caused by Fosamprenavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [58]
Cobicistat DM6L4H2 Major Decreased metabolism of Sirolimus caused by Cobicistat mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [58]
Tipranavir DM8HJX6 Moderate Accelerated clearance of Sirolimus due to the transporter induction by Tipranavir. Human immunodeficiency virus disease [1C60-1C62] [70]
Etravirine DMGV8QU Moderate Increased metabolism of Sirolimus caused by Etravirine mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [58]
Darunavir DMN3GCH Moderate Decreased metabolism of Sirolimus caused by Darunavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [58]
Atazanavir DMSYRBX Major Decreased metabolism of Sirolimus caused by Atazanavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [58]
BMS-201038 DMQTAGO Moderate Decreased clearance of Sirolimus due to the transporter inhibition by BMS-201038. Hyper-lipoproteinaemia [5C80] [71]
Levamlodipine DM92S6N Moderate Decreased metabolism of Sirolimus caused by Levamlodipine mediated inhibition of CYP450 enzyme. Hypertension [BA00-BA04] [58]
Felodipine DMOSW35 Moderate Increased plasma concentrations of Sirolimus and Felodipine due to competitive inhibition of the same metabolic pathway. Hypertension [BA00-BA04] [60]
Tolvaptan DMIWFRL Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Tolvaptan. Hypo-osmolality/hyponatraemia [5C72] [58]
Givosiran DM5PFIJ Major Increased risk of nephrotoxicity by the combination of Sirolimus and Givosiran. Inborn porphyrin/heme metabolism error [5C58] [60]
Lesinurad DMUR64T Moderate Increased metabolism of Sirolimus caused by Lesinurad mediated induction of CYP450 enzyme. Inborn purine/pyrimidine/nucleotide metabolism error [5C55] [72]
Balsalazide DMO091F Major Increased risk of nephrotoxicity by the combination of Sirolimus and Balsalazide. Indeterminate colitis [DD72] [60]
Meclofenamic acid DM05FXR Major Increased risk of nephrotoxicity by the combination of Sirolimus and Meclofenamic acid. Inflammatory spondyloarthritis [FA92] [60]
Berotralstat DMWA2DZ Moderate Decreased metabolism of Sirolimus caused by Berotralstat mediated inhibition of CYP450 enzyme. Innate/adaptive immunodeficiency [4A00] [58]
Amobarbital DM0GQ8N Moderate Increased metabolism of Sirolimus caused by Amobarbital mediated induction of CYP450 enzyme. Insomnia [7A00-7A0Z] [58]
Triazolam DMETYK5 Moderate Increased plasma concentrations of Sirolimus and Triazolam due to competitive inhibition of the same metabolic pathway. Insomnia [7A00-7A0Z] [60]
Zaleplon DMGFWSM Moderate Increased plasma concentrations of Sirolimus and Zaleplon due to competitive inhibition of the same metabolic pathway. Insomnia [7A00-7A0Z] [60]
ITI-007 DMUQ1DO Moderate Increased plasma concentrations of Sirolimus and ITI-007 due to competitive inhibition of the same metabolic pathway. Insomnia [7A00-7A0Z] [60]
Quazepam DMY4D87 Moderate Increased plasma concentrations of Sirolimus and Quazepam due to competitive inhibition of the same metabolic pathway. Insomnia [7A00-7A0Z] [60]
Estazolam DMZGXUM Moderate Increased plasma concentrations of Sirolimus and Estazolam due to competitive inhibition of the same metabolic pathway. Insomnia [7A00-7A0Z] [60]
Glycerol phenylbutyrate DMDGRQO Moderate Increased metabolism of Sirolimus caused by Glycerol phenylbutyrate mediated induction of CYP450 enzyme. Liver disease [DB90-DB9Z] [61]
Denosumab DMNI0KO Moderate Additive immunosuppressive effects by the combination of Sirolimus and Denosumab. Low bone mass disorder [FB83] [73]
Brigatinib DM7W94S Moderate Increased metabolism of Sirolimus caused by Brigatinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [58]
Ceritinib DMB920Z Major Decreased metabolism of Sirolimus caused by Ceritinib mediated inhibition of CYP450 enzyme. Lung cancer [2C25] [58]
PF-06463922 DMKM7EW Moderate Increased metabolism of Sirolimus caused by PF-06463922 mediated induction of CYP450 enzyme. Lung cancer [2C25] [74]
Osimertinib DMRJLAT Moderate Increased metabolism of Sirolimus caused by Osimertinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [61]
Capmatinib DMYCXKL Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Capmatinib. Lung cancer [2C25] [75]
Selpercatinib DMZR15V Moderate Decreased metabolism of Sirolimus caused by Selpercatinib mediated inhibition of CYP450 enzyme. Lung cancer [2C25] [58]
Halofantrine DMOMK1V Moderate Increased plasma concentrations of Sirolimus and Halofantrine due to competitive inhibition of the same metabolic pathway. Malaria [1F40-1F45] [60]
Idelalisib DM602WT Major Decreased metabolism of Sirolimus caused by Idelalisib mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [58]
Moxetumomab pasudotox DMN63DZ Major Increased risk of nephrotoxicity by the combination of Sirolimus and Moxetumomab pasudotox. Mature B-cell leukaemia [2A82] [60]
IPI-145 DMWA24P Moderate Decreased metabolism of Sirolimus caused by IPI-145 mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [58]
Blinatumomab DMGECIJ Moderate Decreased metabolism of Sirolimus caused by Blinatumomab mediated inhibition of CYP450 enzyme. Mature B-cell lymphoma [2A85] [76]
Ibrutinib DMHZCPO Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Ibrutinib. Mature B-cell lymphoma [2A85] [61]
Vemurafenib DM62UG5 Moderate Increased metabolism of Sirolimus caused by Vemurafenib mediated induction of CYP450 enzyme. Melanoma [2C30] [58]
LGX818 DMNQXV8 Moderate Increased metabolism of Sirolimus caused by LGX818 mediated induction of CYP450 enzyme. Melanoma [2C30] [77]
Dabrafenib DMX6OE3 Moderate Increased metabolism of Sirolimus caused by Dabrafenib mediated induction of CYP450 enzyme. Melanoma [2C30] [58]
Ethinyl estradiol DMODJ40 Moderate Increased plasma concentrations of Sirolimus and Ethinyl estradiol due to competitive inhibition of the same metabolic pathway. Menopausal disorder [GA30] [60]
Danazol DML8KTN Moderate Decreased metabolism of Sirolimus caused by Danazol mediated inhibition of CYP450 enzyme. Menstrual cycle bleeding disorder [GA20] [58]
Almogran DM7I64Z Moderate Increased plasma concentrations of Sirolimus and Almogran due to competitive inhibition of the same metabolic pathway. Migraine [8A80] [60]
Lasmiditan DMXLVDT Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Lasmiditan. Migraine [8A80] [78]
Exjade DMHPRWG Major Increased risk of nephrotoxicity by the combination of Sirolimus and Exjade. Mineral absorption/transport disorder [5C64] [79]
Gallium nitrate DMF9O6B Major Increased risk of nephrotoxicity by the combination of Sirolimus and Gallium nitrate. Mineral excesses [5B91] [60]
Tecfidera DM2OVDT Moderate Additive immunosuppressive effects by the combination of Sirolimus and Tecfidera. Multiple sclerosis [8A40] [80]
Siponimod DM2R86O Major Additive immunosuppressive effects by the combination of Sirolimus and Siponimod. Multiple sclerosis [8A40] [58]
Fingolimod DM5JVAN Major Additive immunosuppressive effects by the combination of Sirolimus and Fingolimod. Multiple sclerosis [8A40] [81]
Ocrelizumab DMEZ2KH Moderate Additive immunosuppressive effects by the combination of Sirolimus and Ocrelizumab. Multiple sclerosis [8A40] [82]
Ozanimod DMT6AM2 Major Additive immunosuppressive effects by the combination of Sirolimus and Ozanimod. Multiple sclerosis [8A40] [61]
Deflazacort DMV0RNS Moderate Increased plasma concentrations of Sirolimus and Deflazacort due to competitive inhibition of the same metabolic pathway. Muscular dystrophy [8C70] [60]
Fedratinib DM4ZBK6 Moderate Decreased metabolism of Sirolimus caused by Fedratinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [58]
Nilotinib DM7HXWT Moderate Decreased metabolism of Sirolimus caused by Nilotinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [83]
Dasatinib DMJV2EK Moderate Decreased metabolism of Sirolimus caused by Dasatinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [84]
Omacetaxine mepesuccinate DMPU2WX Moderate Additive immunosuppressive effects by the combination of Sirolimus and Omacetaxine mepesuccinate. Myeloproliferative neoplasm [2A20] [85]
Busulfan DMXYJ9C Moderate Increased plasma concentrations of Sirolimus and Busulfan due to competitive inhibition of the same metabolic pathway. Myeloproliferative neoplasm [2A20] [60]
Rolapitant DM8XP26 Moderate Decreased clearance of Sirolimus due to the transporter inhibition by Rolapitant. Nausea/vomiting [MD90] [86]
Netupitant DMEKAYI Moderate Decreased metabolism of Sirolimus caused by Netupitant mediated inhibition of CYP450 enzyme. Nausea/vomiting [MD90] [58]
Metoclopramide DMFA5MY Moderate Altered absorption of Sirolimus due to GI dynamics variation caused by Metoclopramide. Nausea/vomiting [MD90] [87]
Granisetron DMIUW25 Moderate Increased plasma concentrations of Sirolimus and Granisetron due to competitive inhibition of the same metabolic pathway. Nausea/vomiting [MD90] [60]
Entrectinib DMMPTLH Moderate Decreased metabolism of Sirolimus caused by Entrectinib mediated inhibition of CYP450 enzyme. Non-small cell lung cancer [2C25] [58]
Sibutramine DMFJTDI Moderate Increased plasma concentrations of Sirolimus and Sibutramine due to competitive inhibition of the same metabolic pathway. Obesity [5B80-5B81] [60]
Levomethadyl Acetate DM06HG5 Moderate Increased plasma concentrations of Sirolimus and Levomethadyl Acetate due to competitive inhibition of the same metabolic pathway. Opioid use disorder [6C43] [60]
Rucaparib DM9PVX8 Moderate Decreased metabolism of Sirolimus caused by Rucaparib mediated inhibition of CYP450 enzyme. Ovarian cancer [2C73] [58]
Ibuprofen DM8VCBE Major Increased risk of nephrotoxicity by the combination of Sirolimus and Ibuprofen. Pain [MG30-MG3Z] [60]
Buprenorphine DMPRI8G Moderate Increased plasma concentrations of Sirolimus and Buprenorphine due to competitive inhibition of the same metabolic pathway. Pain [MG30-MG3Z] [60]
Bromocriptine DMVE3TK Moderate Decreased metabolism of Sirolimus caused by Bromocriptine mediated inhibition of CYP450 enzyme. Parkinsonism [8A00] [58]
Abametapir DM2RX0I Moderate Decreased metabolism of Sirolimus caused by Abametapir mediated inhibition of CYP450 enzyme. Pediculosis [1G00] [88]
Bromfenac DMKB79O Major Increased risk of nephrotoxicity by the combination of Sirolimus and Bromfenac. Postoperative inflammation [1A00-CA43] [60]
Ergonovine DM0VEC1 Moderate Increased plasma concentrations of Sirolimus and Ergonovine due to competitive inhibition of the same metabolic pathway. Postpartum haemorrhage [JA43] [60]
Lonafarnib DMGM2Z6 Major Decreased metabolism of Sirolimus caused by Lonafarnib mediated inhibition of CYP450 enzyme. Premature ageing appearance [LD2B] [58]
Enzalutamide DMGL19D Major Increased metabolism of Sirolimus caused by Enzalutamide mediated induction of CYP450 enzyme. Prostate cancer [2C82] [58]
Bicalutamide DMZMSPF Moderate Decreased metabolism of Sirolimus caused by Bicalutamide mediated inhibition of CYP450 enzyme. Prostate cancer [2C82] [58]
Dutasteride DMQ4TJK Moderate Increased plasma concentrations of Sirolimus and Dutasteride due to competitive inhibition of the same metabolic pathway. Prostate hyperplasia [GA90] [60]
Finasteride DMWV3TZ Moderate Increased plasma concentrations of Sirolimus and Finasteride due to competitive inhibition of the same metabolic pathway. Prostate hyperplasia [GA90] [60]
Ustekinumab DMHTYK3 Moderate Additive immunosuppressive effects by the combination of Sirolimus and Ustekinumab. Psoriasis [EA90] [61]
Tildrakizumab DMLW9HG Moderate Additive myelosuppressive effects by the combination of Sirolimus and Tildrakizumab. Psoriasis [EA90] [61]
Risankizumab DMM32GT Moderate Additive myelosuppressive effects by the combination of Sirolimus and Risankizumab. Psoriasis [EA90] [61]
Ixekizumab DMXW92T Moderate Additive myelosuppressive effects by the combination of Sirolimus and Ixekizumab. Psoriasis [EA90] [61]
Colistimethate DMZ9BMU Major Increased risk of nephrotoxicity by the combination of Sirolimus and Colistimethate. Respiratory infection [CA07-CA4Z] [60]
Salsalate DM13P4C Major Increased risk of nephrotoxicity by the combination of Sirolimus and Salsalate. Rheumatoid arthritis [FA20] [60]
Tocilizumab DM7J6OR Moderate Additive myelosuppressive effects by the combination of Sirolimus and Tocilizumab. Rheumatoid arthritis [FA20] [61]
Canakinumab DM8HLO5 Moderate Additive myelosuppressive effects by the combination of Sirolimus and Canakinumab. Rheumatoid arthritis [FA20] [61]
Oxaprozin DM9UB0P Major Increased risk of nephrotoxicity by the combination of Sirolimus and Oxaprozin. Rheumatoid arthritis [FA20] [60]
Rilonacept DMGLUQS Moderate Additive myelosuppressive effects by the combination of Sirolimus and Rilonacept. Rheumatoid arthritis [FA20] [61]
Golimumab DMHZV7X Major Additive immunosuppressive effects by the combination of Sirolimus and Golimumab. Rheumatoid arthritis [FA20] [89]
Dexamethasone DMMWZET Moderate Increased metabolism of Sirolimus caused by Dexamethasone mediated induction of CYP450 enzyme. Rheumatoid arthritis [FA20] [58]
Sarilumab DMOGNXY Moderate Additive myelosuppressive effects by the combination of Sirolimus and Sarilumab. Rheumatoid arthritis [FA20] [61]
Leflunomide DMR8ONJ Major Additive myelosuppressive effects by the combination of Sirolimus and Leflunomide. Rheumatoid arthritis [FA20] [90]
Quetiapine DM1N62C Moderate Increased plasma concentrations of Sirolimus and Quetiapine due to competitive inhibition of the same metabolic pathway. Schizophrenia [6A20] [60]
Aripiprazole DM3NUMH Moderate Increased plasma concentrations of Sirolimus and Aripiprazole due to competitive inhibition of the same metabolic pathway. Schizophrenia [6A20] [60]
Pimozide DMW83TP Moderate Increased plasma concentrations of Sirolimus and Pimozide due to competitive inhibition of the same metabolic pathway. Schizophrenia [6A20] [60]
Anthrax vaccine DM9GSWY Moderate Antagonize the effect of Sirolimus when combined with Anthrax vaccine. Sepsis [1G40-1G41] [91]
Voxelotor DMCS6M5 Moderate Decreased metabolism of Sirolimus caused by Voxelotor mediated inhibition of CYP450 enzyme. Sickle-cell disorder [3A51] [58]
Telotristat ethyl DMDIYFZ Moderate Increased metabolism of Sirolimus caused by Telotristat ethyl mediated induction of CYP450 enzyme. Small intestine developmental anomaly [DA90] [61]
Larotrectinib DM26CQR Moderate Decreased metabolism of Sirolimus caused by Larotrectinib mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [58]
Methylprednisolone DM4BDON Moderate Increased plasma concentrations of Sirolimus and Methylprednisolone due to competitive inhibition of the same metabolic pathway. Solid tumour/cancer [2A00-2F9Z] [60]
Ifosfamide DMCT3I8 Moderate Increased plasma concentrations of Sirolimus and Ifosfamide due to competitive inhibition of the same metabolic pathway. Solid tumour/cancer [2A00-2F9Z] [60]
Docetaxel DMDI269 Moderate Increased plasma concentrations of Sirolimus and Docetaxel due to competitive inhibition of the same metabolic pathway. Solid tumour/cancer [2A00-2F9Z] [60]
Armodafinil DMGB035 Moderate Increased metabolism of Sirolimus caused by Armodafinil mediated induction of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [58]
LEE011 DMMX75K Moderate Decreased metabolism of Sirolimus caused by LEE011 mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [58]
Taxol DMUOT9V Moderate Increased plasma concentrations of Sirolimus and Taxol due to competitive inhibition of the same metabolic pathway. Solid tumour/cancer [2A00-2F9Z] [60]
Doxorubicin DMVP5YE Moderate Increased plasma concentrations of Sirolimus and Doxorubicin due to competitive inhibition of the same metabolic pathway. Solid tumour/cancer [2A00-2F9Z] [60]
Telavancin DM58VQX Major Increased risk of nephrotoxicity by the combination of Sirolimus and Telavancin. Staphylococcal/streptococcal disease [1B5Y] [60]
Fostamatinib DM6AUHV Moderate Decreased metabolism of Sirolimus caused by Fostamatinib mediated inhibition of CYP450 enzyme. Thrombocytopenia [3B64] [92]
Brilinta DMBR01X Moderate Decreased metabolism of Sirolimus caused by Brilinta mediated inhibition of CYP450 enzyme. Thrombosis [DB61-GB90] [61]
Olsalazine DMZW9HA Major Increased risk of nephrotoxicity by the combination of Sirolimus and Olsalazine. Ulcerative colitis [DD71] [60]
Plazomicin DMKMBES Major Increased risk of nephrotoxicity by the combination of Sirolimus and Plazomicin. Urinary tract infection [GC08] [60]
Elagolix DMB2C0E Moderate Increased metabolism of Sirolimus caused by Elagolix mediated induction of CYP450 enzyme. Uterine fibroid [2E86] [58]
Amiodarone DMUTEX3 Moderate Increased plasma concentrations of Sirolimus and Amiodarone due to competitive inhibition of the same metabolic pathway. Ventricular tachyarrhythmia [BC71] [60]
⏷ Show the Full List of 183 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
Allura red AC dye E00338 33258 Colorant
Alpha-tocopherol E00243 14985 Antimicrobial preservative; Antioxidant
Glyceryl monooleate E00473 5283468 Bioadhesive material; Emollient; Emulsifying agent; Emulsion stabilizing agent; Gelling agent; Modified-release agent; Surfactant
Hydrazine yellow E00409 164825 Colorant
Mannitol E00103 6251 Diluent; Flavoring agent; Lyophilization aid; Plasticizing agent; Tonicity agent
Tocopheryl acetate E00053 86472 Antioxidant
Ammonia E00007 222 Alkalizing agent
Beta-D-lactose E00099 6134 Diluent; Dry powder inhaler carrier; Lyophilization aid
Calcium sulfate anhydrous E00303 24497 Desiccant; Diluent
Citric acid monohydrate E00271 22230 Acidulant; Antioxidant; Buffering agent; Complexing agent; Flavoring agent
Crospovidone E00626 Not Available Disintegrant
Eisenoxyd E00585 56841934 Colorant
Ferric hydroxide oxide yellow E00539 23320441 Colorant
Lactose monohydrate E00393 104938 Binding agent; Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate E00208 11177 lubricant
Poloxamer 188 E00645 Not Available Emulsifying agent; Solubilizing agent; Surfactant
Povidone E00667 Not Available Binding agent; Coating agent; Disintegrant; Film/membrane-forming agent; Solubilizing agent; Suspending agent
Propylene glycol E00040 1030 Antimicrobial preservative; Humectant; Plasticizing agent; Solvent
Saccharose E00091 5988 Binding agent; Coating agent; Cryoprotectant; Diluent; Flavoring agent; Suspending agent; Viscosity-controlling agent
Talc E00520 16211421 Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide E00322 26042 Coating agent; Colorant; Opacifying agent
Vinylpyrrolidone E00668 Not Available Binding agent; Coating agent; Disintegrant; Film/membrane-forming agent; Solubilizing agent; Suspending agent
⏷ Show the Full List of 22 Pharmaceutical Excipients of This Drug
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Sirolimus 2 mg tablet 2 mg Oral Tablet Oral
Sirolimus 1 mg tablet 1 mg Oral Tablet Oral
Sirolimus 0.5 mg tablet 0.5 mg Oral Tablet Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

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