雷帕鸣有什么注意事项？

Sirolimus is a targeted inhibitor of the target of rapamycin (roTOR). It is a powerful immunosuppressant. It not only has low nephrotoxicity, anti-proliferation, anti-tumor effects, etc., and can benefit kidney transplant patients, but also has good curative effect on lymphangioleiomyomatosis (LAM).

However, despite this, patients will still experience some side effects and other serious adverse events during the actual continuous treatment with rapamycin. In order to reduce the damage caused by medication as much as possible, patients must pay great attention to the following aspects:

1. It is recommended that sirolimus (i.e. rapamycin) oral solution be used in combination with cyclosporine and corticosteroids. The loading dose is 6 mg on the first day, 2 mg/day within 2 weeks (the dose can be reduced if adverse reactions occur), and 1-2 mg/day after 2 weeks.

2. In order to minimize the difference in absorption of this drug, this drug should be taken regularly with or without food. Grapefruit juice slows the metabolism of sirolimus as regulated by CYP3A4 and should not be used to deliver or dilute sirolimus oral solutions.

3. It is recommended to take sirolimus 4 hours after taking cyclosporine oral solution (microemulsion) and/or cyclosporine capsule (microemulsion).

4. Dosage adjustment:

(1) For patients over 13 years old but weighing no more than 40kg, the starting dose should be adjusted to 1mg/m²/day based on the body surface area, and the loading dose should be 3mg/m². It is recommended that the maintenance dose of this drug be reduced by approximately 1/3 in patients with liver function impairment, but the loading dose does not need to be adjusted. Sirolimus pharmacokinetic studies have not been conducted in patients with severe hepatic impairment.

(2) The dose does not need to be adjusted in patients with renal impairment.

5. Handling and disposal: Since Rapamin is not absorbed through the skin, there are no special precautions. However, if it accidentally comes into direct contact with skin or mucous membranes, wash it thoroughly with soap and water; rinse your eyes with clean water.