雷帕鸣的注意事项有什么呢？

Rapamin (sirolimus tablets, sirolimus) is suitable for patients aged 13 or above who have received kidney transplants to prevent organ rejection. It is recommended that sirolimus be used in combination with cyclosporine and corticosteroids. Monitoring of therapeutic drug plasma concentrations is recommended for all patients receiving sirolimus. Sirolimus should only be used by physicians experienced with immunosuppressive therapy and managing kidney transplant patients. Patients receiving this drug should be treated in an institution with appropriate laboratory and ancillary medical facilities and personnel. What should Lei Panming pay attention to?

Hypersensitivity reactions: Hypersensitivity reactions associated with the administration of rapamin include anaphylactic/anaphylactoid reactions, angioedema, exfoliative dermatitis, and allergic vasculitis.

Angioedema: Rapamin administration has been associated with the development of angioedema. The risk of angioedema development may be increased when sirolimus is coadministered with other drugs known to cause angioedema, such as angiotensin-converting enzyme inhibitors.

Hyperlipidemia: Use of rapamycin in renal transplant patients has the potential to cause elevations in serum cholesterol and triglycerides requiring treatment. Therefore, patients must be monitored for the development of hyperlipidemia.

Interactions with Strong Inhibitors and Inducers of CYP3A4 and/or P-gp: Coadministration of rapamycin with strong inhibitors of CYP3A4 and/or P-gp (e.g., ketoconazole, voriconazole, itraconazole, erythromycin, telithromycin, and clarithromycin) or strong inducers of CYP3A4 and/or P-gp (e.g., rifampicin and rifabutin) is not recommended. Rapamin is extensively metabolized in the intestinal wall and liver by the CYP3A4 isoenzyme. Inhibitors of CYP3A4 can slow down the metabolism of sirolimus and increase the plasma concentration of sirolimus. Inducers of CYP3A4 accelerate the metabolism of rapamycin and decrease the plasma concentration of sirolimus.