What is the normal concentration of sirolimus?

Sirolimus (sirolimus) is a macrolide antibiotic isolated from Streptomyces hygroscopicus. It inhibits the proliferation of T cells and B cells by inhibiting the protein kinase mTOR. It has no effect on calcineurin and therefore can be used with or as an alternative to cyclosporine or tacrolimus. The side effects of sirolimus are concentration dependent, so therapeutic drug monitoring is critical.

The scope of treatment with sirolimus may vary depending on transplant type, regimen, and concomitant medications. Most people show the best response to sirolimus, with whole blood trough concentrations of 4-20 ng/mL. Some patients may require higher trough levels between 20-30ng/mL. Pharmacokinetic interactions between sirolimus and cyclosporine or tacrolimus increase therapeutic immunosuppression and toxicity. Therefore, lower doses are required for combination therapy. When combined with cyclosporine or tacrolimus, the therapeutic range of sirolimus is usually between 4 and 12 ng/dL.

SirolimusThe original drug has been launched in China and has entered the scope of Class B medical insurance. SpecificationsThe price of each box of 1mg*10 tablets is about 400 yuan. The domestic drug is only available to patients with anti-rejection reactions in organ transplantation. Patients who do not meet the conditions may not be able to purchase this drug. The original sirolimus drug has also been launched overseas. The price of the Turkish version of Specifications1mg*100 tablets per box is around RMB 2,000 (the price may fluctuate due to exchange rates). The ingredients of the original drugs marketed in China are basically the same as those of foreign original drugs. Currently, there are no generic sirolimus drugs produced in other countries.