吃雷帕鸣(西罗莫司片)要注意什么？

It is suitable for patients undergoing kidney transplantation to prevent organ rejection. It is recommended to be used in combination with cyclosporine and corticosteroids. What should I pay attention to when taking rapamycin (sirolimus tablets)?

1. Hyperlipidemia: May increase blood lipids (cholesterol and triglycerides). Use with caution in patients with hyperlipidemia. Monitor cholesterol/lipids; if hyperlipidemia occurs, follow current management guidelines (diet, exercise, lipid-lowering agents). Antihyperlipidemic treatments may not be effective in achieving normal levels. 

2. Lymphocele/effusion: Peripheral edema, lymphedema, ascites, and thoracic and pericardial effusions (including severe effusions and cardiac tamponade) have been reported; use with caution in patients with poor tolerance to fluid accumulation, such as cardiovascular disease (heart failure or hypertension) and pulmonary disease. 

3. Malignant tumors: Increased risk of skin cancer; limit sunlight and ultraviolet exposure; use appropriate sun protection measures. 

4. Proteinuria: Increased urinary protein excretion was observed in renal transplant patients when they were switched from calcineurin inhibitors to rapamycin during maintenance therapy. Higher levels of proteinuria before rapamycin conversion were associated with higher levels of proteinuria after conversion. In some patients, proteinuria may reach nephrotic levels; nephrotic syndrome (new onset) has been reported.

5. Liver damage: Use with caution in patients with hepatic insufficiency; it is recommended to reduce the maintenance dose. 

6. Fetal toxicity: Effective contraceptive measures should be taken before starting treatment with rapamin, during treatment and within 12 weeks after stopping. During pregnancy, rapamin should be used only if the potential benefits outweigh the potential risks to the embryo/fetus.

7. It is prohibited to be used by patients and lactating women who are allergic to rapamycin derivatives or any ingredients in the oral solution of this drug.

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