用雷帕鸣治疗时需要注意什么？

Sirolimus is mainly used in clinical practice to prevent and treat rejection of kidney, liver and other transplants, especially for patients with renal dysfunction, tremor, and hypertension. The combination of this drug and cyclosporine can produce a synergistic effect that is more effective than either one alone, and more effective than the combination of sirolimus plus mycophenolate mofetil or cyclosporine plus mycophenolate mofetil.

Despite this, patients will still experience some adverse reactions during the actual treatment with this drug, which may even lead to various adverse events, posing a certain threat to the patient's health and life. In this regard, patients must pay attention to the following aspects:

(1) This medicine is to be taken orally, once a day.

(2) Patients should start taking it as soon as possible after receiving a kidney transplant. New transplant recipients should take a loading dose for the first time, which is three times their 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.

(3) Patients who are allergic to sirolimus, sirolimus derivatives, or any ingredients in the oral solution of this drug, as well as pregnant and lactating women, should not use this drug.

(4) Since grapefruit juice can slow down the metabolism of this drug regulated by CYP3A4 to varying degrees, it is best for patients not to use grapefruit juice to take or dilute this drug when taking rapamycin.

(5) It is recommended to take sirolimus 4 hours after taking cyclosporine oral solution (improved version) and/or cyclosporine capsules (improved version).

(6) Due to the different dosage forms and specifications of rapamin (sirolimus), its usage and dosage may vary. Therefore, patients must carefully read the specific drug instructions or follow the doctor's advice before receiving treatment with this drug.