西罗莫司片能常年吃吗？

Can sirolimus tablets be taken all year round? Experts explain that long-term use will have toxic effects, so patients are advised not to take sirolimus tablets (rapamin) for a long time.

Sirolimus is suitable for patients 13 years of age or older who have received kidney transplants to prevent organ rejection. Administer orally, once daily. It should be started as soon as possible after transplantation. For new transplant recipients, the loading dose that should be taken for the first time is three times the maintenance dose. The recommended loading dose for kidney transplant patients is 6 mg and the maintenance dose is 2 mg/day. Although the loading dose of 15 mg and the maintenance dose of 5 mg/day used in clinical trials are safe and effective, the therapeutic benefits of doses above 2 mg are unclear for kidney transplant patients. The overall safety profile of patients taking 2 mg of rapamide daily was better than that of patients taking 5 mg rapamide daily.

To minimize differences in the proper absorption of sirolimus, the drug should be taken regularly with or without food. Grapefruit juice slows down the metabolism of rapamin, which is regulated by CYP3A4, and should not be used to deliver or dilute rapamin. It is recommended that 4 hours after taking cyclosporine oral solution (improved type) (such as Neoral oral solution, SangCya oral solution) and/or cyclosporine capsules (improved type), take rapamycin (sirolimus tablets) at the same time or 4 hours after taking cyclosporine. The average Cmax and AUC of rapamin (sirolimus tablets) will not be significantly affected. However, within 6 months after kidney transplantation, the patient took multiple doses of rapamycin (4 hours after taking cyclosporine). The oral drug clearance rate of cyclosporine decreased, and a smaller dose of cyclosporine (Neoral) was needed to maintain the target concentration of cyclosporine.

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