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Sirolimus Coupon - Sirolimus 1mg tablet

sirolimus

Generic Rapamune
Used for Organ Transplant
Used for Organ Transplant

Sirolimus (Rapamune) lowers the activity of your immune system to prevent rejection after a kidney transplant. It can also help with a condition that affects your lymphatic system, which is related to your immune system. Your provider will check the levels of sirolimus (Rapamune) in your blood, and this will help guide the dosing. Sirolimus (Rapamune) is available as tablets and as an oral solution, and it's usually only taken once a day. Common side effects include changes in your lab values (e.g., more cholesterol and fat in the blood, change in kidney labs), which is another reason to get your blood checked regularly while taking this medication.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Connie Zheng, PharmD
Last reviewed on June 1, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Sirolimus (Rapamune)?

What is Sirolimus (Rapamune) used for?

How Sirolimus (Rapamune) works

Sirolimus (Rapamune) is an immunosuppressant that lowers the activity of your immune system. You need a suppressed (lowered) immune system after receiving a transplant so your body doesn't reject the new kidney.

Are you looking for information on everolimus (Zortress) instead?

Drug Facts

Common BrandsRapamune
Drug ClassImmunosuppressant
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$1362.49

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What are the side effects of Sirolimus (Rapamune)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Swelling in arms and legs (up to 58%)
  • More cholesterol and fat in the blood (up to 57%)
  • High blood pressure (up to 49%)
  • Change in kidney labs (up to 40%)
  • Constipation (up to 36%)
  • Headache (up to 34%)
  • Pain (up to 33%)
  • Stomach pain (up to 29%)
  • Urinary tract infection (up to 26%)

Other Side Effects

  • Fever
  • Acne
  • Diarrhea
  • Muscle pain
  • Nausea

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Infection: fever, chills, fatigue, muscle aches
  • Serious lung problems (interstitial lung disease): breathing problems, chest pain, cough, tiredness
  • Serious allergic reaction: trouble breathing, swelling of the face, tightening of the throat, rash, hives, welts, peeling or blistering skin

Source: DailyMed

More on Sirolimus (Rapamune) side effects

sirolimus: side effects sirolimus

9 Sirolimus Side Effects You Should Know About

Written by Kevin Le, PharmD, BCPS, BCPPS

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Abdominal or stomach cramps or pain

accumulation of pus

anxiousness, unexplained

backache

black or red, tarry stools

bleeding from the gums or nose

blurred vision

body aches or pain

bone pain

bruising

burning or stinging of the skin

burning while urinating

burning, dry, or itching eyes

burning, tingling, numbness, or pain in the hands, arms, feet, or legs

change in mental status

changes in skin color

chest pain

chills

confusion

convulsions (seizures)

cough

dark or bloody urine

deafness

decreased urine output

decreased vision

difficulty with breathing or swallowing

dilated neck veins

discharge from the eyes

dizziness

drowsiness

dry mouth

earache

excessive tearing

extreme fatigue

eye pain

facial hair growth in females

faintness or lightheadedness when getting up from lying or sitting position

fast, slow, or irregular heartbeat

fever

flushing or redness of the skin, especially on the face and neck

general feeling of discomfort or illness

increased hunger

increased menstrual flow or vaginal bleeding

itching, pain, redness, swelling, tenderness, or warmth on the skin

lack or loss of appetite

large, flat, blue, or purplish patches in the skin

loss of sexual ability, desire, drive, or performance

loss of voice

muscle pain

nasal congestion

nausea or vomiting

numbness or tingling around the lips, hands, or feet

pain in the chest, groin, or legs, especially the calves

painful cold sores or blisters on the lips, nose, eyes, or genitals

pale skin

prolonged bleeding from cuts

rapid heartbeat

rash

red or dark brown urine

redness or swelling in the ear

redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid

ringing in the ears

runny nose

sensation of pins and needles

severe constipation

severe vomiting

severe, sudden headache

slurred speech

sore throat

sores or white spots on the lips or in the mouth

stomach pain or upset

sudden decrease in the amount of urine

sudden loss of coordination

sudden, severe weakness or numbness in the arm or leg

sudden, unexplained shortness of breath

sweating

swollen, painful, or tender lymph glands in the neck, armpit, or groin

tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over affected area

tremor

ulcers on the lips or in the mouth

unusual tiredness or weakness

vision changes

weakness or heaviness of the legs

white patches in the mouth or on the tongue

yellow skin and eyes

Less common

Bloating

change in size, shape, or color of existing mole

hoarseness

mole that leaks fluid or bleeds

new mole

pains in the stomach, side or abdomen, possibly radiating to the back

skin ulcer or sores

Incidence not known

Abnormal wound healing

headache

hives or itching

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

nails loose or detached

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

swelling of the arms or legs

yellow nails lacking a cuticle

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abnormal vision

acne

belching

blistering, crusting, irritation, itching, or reddening of the skin

burning feeling in the chest or stomach

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feeling

constipation

continuing ringing or buzzing or other unexplained noise in the ears

cracked, dry, or scaly skin

crying

decrease in frequency of urination

degenerative disease of the joint

depersonalization

diarrhea

difficulty with moving

difficulty with passing urine (dribbling)

dysphoria

ear pain

enlarged abdomen or stomach

euphoria

excess air or gas in the stomach or intestines

excessive muscle tone, muscle tension or tightness

fear

feeling sad or empty

hearing loss

heartburn

inability to have or keep an erection

increase in heart rate

increased hair growth, especially on the face

increased urge to urinate during the night

indigestion

irritation in the mouth

joint pain or swelling

leg cramps

loss of bladder control

loss of energy or weakness

loss of interest or pleasure

loss of strength

lower abdominal or stomach pain

muscle aches, pain, stiffness, or weakness

nervousness

pain in the back, ribs, arms, or legs

pain or burning in the throat

pain or tenderness around the eyes and cheekbones

paranoia

pelvic pain

quick to react or overreact emotionally

rapid breathing

rapidly changing moods

inflammation, redness, or swelling of the gums or mouth

shaking or trembling

shivering

sleepiness

sunken eyes

swelling

swelling of the scrotum

tender or enlarged gums

tenderness in the stomach area

thickening of the skin

trouble concentrating

trouble sleeping

waking to urinate at night

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Sirolimus (Rapamune)

thumbs-up

Pros

Taken once a day

Can be taken with or without food

Comes as an oral solution for people who have a hard time swallowing pills

Available as a generic medication, which can be less expensive

thumbs-down

Cons

Not meant for children age 12 and younger

Not a good option during pregnancy

Can cause fertility problems

Must be used with other immunosuppressants

pharmacist-tips

Pharmacist tips for Sirolimus (Rapamune)

pharmacist

  • Take sirolimus (Rapamune) at the same time every day. If you're taking it with cyclosporine (Neoral), be sure to take sirolimus (Rapamune) 4 hours after cyclosporine (Neoral).

    • Swallow the tablets whole. Don’t crush, chew, or split them. If you have a hard time swallowing the tablets, ask your provider about the oral solution.

      • Talk to your transplant team about family planning. Sirolimus (Rapamune) can affect fertility and harm an unborn baby. Women who can become pregnant should use reliable birth control while they're taking sirolimus (Rapamune) and for 12 weeks after the medication is stopped. Talk to your provider about your options for birth control or if you wish to become pregnant; there are anti-rejection medications that might be safer in pregnancy.

        • Many medications can change the amount of sirolimus (Rapamune) in your body. Talk to your transplant provider before starting any medication or supplement.

          • Avoid grapefruit, pomelo, pomegranate, and Seville oranges while on sirolimus (Rapamune). These citrus fruits and their juices can interact with sirolimus (Rapamune) and cause the levels to get too high in your body, which can be very dangerous.

            More tips for sirolimus (Rapamune) oral solution:

            • Store sirolimus (Rapamune) oral solution in the fridge. If you don't have a fridge, you can store the solution at room temperature for up to 15 days. Any medication leftover after 15 days at room temperature should be thrown away. Bottles of sirolimus (Rapamune) in the fridge are good for 30 days after they're opened.

              • Sometimes the sirolimus (Rapamune) solution turns hazy in the fridge. This doesn't mean the medication has gone bad. If you see a slight haze in the bottle, let it sit at room temperature and then gently shake the bottle until the haze goes away.

                • If needed, sirolimus (Rapamune) oral solution can be mixed with 2 ounces of water or orange juice, but no other liquids. Once added to water or orange juice, stir the mixture well and then drink it right away.

                  faqs

                  Frequently asked questions about Sirolimus (Rapamune)

                  How long does sirolimus (Rapamune) stay in your system?
                  Sirolimus (Rapamune) stays in your body longer than its newer counterpart, everolimus (Zortress). This means that sirolimus (Rapamune) can be taken once a day, whereas everolimus (Zortress) is taken twice a day. Even though it lasts longer, you still need to take sirolimus (Rapamune) every day as directed in order to maintain a "target" level in your blood. Missing doses can lead to rejection or worsening of your condition if you're taking it for LMA.
                  What's the difference between sirolimus (Rapamune) and tacrolimus (Prograf)?
                  Sirolimus (Rapamune) and tacrolimus (Prograf) are both immunosuppressants that prevent organ rejection, but they work differently to do so. Tacrolimus (Prograf) is a calcineurin inhibitor that blocks your immune cells (T cells) from activating, growing, and attacking your new organ. Sirolimus (Rapamune), on the other hand, stops a protein called mTOR, which your immune system needs in order to make fighter cells and antibodies. Tacrolimus (Prograf) can be used to prevent heart, liver, and kidney transplant rejection, whereas sirolimus (Rapamune) is only approved to prevent kidney transplant rejection. Both immunosuppressants are adjusted based on blood levels. If you've had a kidney transplant, talk to your transplant provider about which would be best for you.
                  Is sirolimus (Rapamune) the same as rapamycin?
                  Yes, sirolimus (Rapamune) and rapamycin are different names for the same medication. Scientists originally discovered the medication from a soil sample in Easter Island and named it rapamycin. The U.S. pharmaceutical world named the generic medication, sirolimus.
                  Why do I need blood draws for sirolimus (Rapamune) levels?
                  Blood draws are important because your provider determine your dose of sirolimus (Rapamune) based on its level in your blood. If your sirolimus (Rapamune) level is too low, you're at higher risk for transplant rejection. If it's high, it can lead to side effects. If you've had a kidney transplant, your transplant team will provide you with a schedule that will tell you which days to go for blood draws.
                  Should I take sirolimus (Rapamune) with food?
                  Sirolimus (Rapamune) can be taken with or without food, but it's important to be consistent (either always take it with food or always take it without food). Food in your stomach can change how much of the medication is absorbed, which means your levels might be too high or too low if you switch between taking the medication with food or on an empty stomach. If you usually get an upset stomach with medications, taking sirolimus (Rapamune) with food might be a good choice for you.
                  How does sirolimus (Rapamune) prevent rejection?
                  When a new organ is placed into your body, your immune system sees it as a foreign object and will want to get rid of it. The immune system's response can lead to a lot of inflammation, which will damage the new organ. Sirolimus (Rapamune) stops a protein called mTOR, which your immune system needs in order to make fighter cells and antibodies. This results in a lower immune system that isn't able to reject your new organ.
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                  What are the risks and warnings for Sirolimus (Rapamune)?

                  Sirolimus (Rapamune) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Risk for cancer

                  • Risk factors: Long-term use

                    Though not common, long-term use of sirolimus (Rapamune) can cause skin cancer, as well as lymphoma (a cancer of the immune system). Limit your exposure to sunlight and ultraviolet light, wear protective clothing, and use sunblock. Also, make sure to keep up your blood work appointments so your provider can make sure this medication remains safe for you.

                    risk-warning

                    Serious infections

                    • Risk factors: Taking other immunosuppressants

                      Sirolimus (Rapamune) can raise your risk of serious or life-threatening bacterial, fungal, and viral infections. Be sure to stay away from people who are sick. Wash your hands often. In some cases, infections can happen when an inactive virus in your body, like tuberculosis (TB) or hepatitis B virus (HBV), reactivates (makes you sick again). If you develop symptoms of fever, chills, muscle aches, change in appetite or weight loss, vomiting, or skin rash, tell your transplant provider right away.

                      risk-warning

                      Not recommended for liver and lung transplants

                      Sirolimus (Rapamune) isn't recommended for the prevention of rejection after liver and lung transplants. During clinical trials for liver transplants, people using sirolimus (Rapamune) had a higher risk of serious problems including death. There have also been reports of deadly breathing complications when used for lung transplants.

                      risk-warning

                      Slower wound healing

                      • Risk factors: BMI greater than 30 | Higher levels of sirolimus (Rapamune)

                        Sirolimus (Rapamune) can make it harder for your body to heal itself. This can be a problem when your body is recovering from surgery and is more likely to happen in people who are obese and those on higher doses of sirolimus (Rapamune). Your transplant team will monitor your healing process closely.

                        risk-warning

                        High lipids (cholesterol and triglycerides)

                        Sirolimus (Rapamune) can raise your cholesterol and triglyceride levels and put you at risk for heart problems. Your provider will monitor your labs and might recommend exercise and dietary changes that can help lower your levels. If the levels remain high, your provider can prescribe a cholesterol-lowering medication like a "statin."

                        risk-warning

                        Serious medication interactions

                        Sirolimus (Rapamune) can interact with many medications. Certain interactions, such as with erythromycin and rifampin (Rifadin), can be more dangerous because they lower the levels of sirolimus (Rapamune) in your body. When this happens, there's a higher chance that your body will reject the new transplant. Other medications might raise the level of sirolimus (Rapamune) in your body and make it more likely for you to experience side effects. Let your provider know what other medications you're currently taking so they can help check for interactions.

                        risk-warning

                        Kidney damage

                        • Risk factors: Taking other medications that can damage kidneys | Long-term use of sirolimus (Rapamune)

                          Your kidney health will be closely monitored after your kidney transplant. Some of your anti-rejection medications, like sirolimus (Rapamune), can slow down your kidney function and lead to protein in your urine. It's more likely to happen the longer you take sirolimus (Rapamune) and if you take other medications that can damage your kidney. If your provider suspects kidney damage, they can lower your dose or switch you to another medication to see if that helps.

                          risk-warning

                          Harm to unborn babies and lower sperm count

                          Sirolimus (Rapamune) can harm unborn babies and shouldn't be used during pregnancy. Females who want to become pregnant should continue to avoid pregnancy for 3 months after stopping the medication. Males taking sirolimus (Rapamune) can experience lower sperm counts. Family planning is an important conversation to have with your transplant provider to discuss your anti-rejection options.

                          risk-warning

                          Vaccines

                          Transplant medications like sirolimus (Rapamune) can change the way your immune system responds to vaccines. Avoid live vaccines while taking this medication because they can make you sick. Also be sure to stay away from people who recently got a live vaccine, because they could make you sick. Always tell your provider or pharmacist that you're taking an immunosuppressant like sirolimus (Rapamune) before getting vaccinated and they can let you know if it's a live vaccine or not.

                          dosage

                          Sirolimus (Rapamune) dosage forms

                          The average cost for 90 tablets of 1mg of Sirolimus (Rapamune) is $1035.00 with a free GoodRx coupon. This is 24.04% off the average retail price of $1362.49.
                          bottle of oral solution
                          Bottle of oral solution
                          DosageQuantityPrice as low asPrice per unit
                          60ml of 1mg/ml1 bottle$1957.00$1957.00
                          tablet
                          Tablet
                          DosageQuantityPrice as low asPrice per unit
                          0.5mg30 tablets$521.00$17.37
                          1mg30 tablets$1035.00$34.50
                          2mg50 tablets$3416.00$68.32

                          Typical dosing for Sirolimus (Rapamune)

                          Prevention of kidney transplant rejection

                          • If you have a lower risk of rejection: The typical starting dose is 6 mg by mouth on the day after your transplant, followed by 2 mg by mouth every day.

                          • If you have a higher risk of rejection: The typical starting dose is 15 mg by mouth on the day after your transplant, followed by 5 mg by mouth every day.

                          Your provider will adjust your dose based on the level of medication in your blood.

                          Lymphangioleiomyomatosis

                          • The typical starting dose is 2 mg by mouth every day. Your provider will likely measure the level of medication in your blood after a few weeks and will adjust your dose accordingly.

                          interactions

                          Interactions between Sirolimus (Rapamune) and other drugs

                          Sirolimus (Rapamune) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sirolimus (Rapamune). Please note that only the generic name of each medication is listed below.

                          Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                          Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                          drug-cost

                          How much does Sirolimus (Rapamune) cost?

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                          alternatives

                          What are alternatives to Sirolimus (Rapamune)?

                          There are a number of medications that your doctor can prescribe in place of Sirolimus (Rapamune). Compare a few possible alternatives below.
                          Sirolimus (Rapamune)
                          Used for:
                          $78.88 Lowest GoodRx priceView Prices
                          Everolimus (Zortress)
                          Used for:
                          $114.98 Lowest GoodRx priceView Prices
                          Tacrolimus (Prograf)
                          Used for:
                          $36.00 Lowest GoodRx priceView Prices
                          images

                          Sirolimus (Rapamune) images

                          White Triangle Rd 53 - Sirolimus 1mg Tablet
                          This medicine is White, Triangle Tablet Imprinted With "Rd 53".White Triangle Rd 53 - Sirolimus 1mg Tablet
                          White Triangle Rapamune 1 Mg - Sirolimus 1mg Tablet
                          This medicine is White, Triangle Tablet Imprinted With "Rapamune 1 Mg".White Triangle Rapamune 1 Mg - Sirolimus 1mg Tablet
                          White Round 11 - Sirolimus 1mg Tablet
                          This medicine is White, Round Tablet Imprinted With "11".White Round 11 - Sirolimus 1mg Tablet

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                          References

                          Best studies we found

                          Amneal Pharmaceuticals NY LLC. (2022). SIROLIMUS solution [package insert]. DailyMed.

                          Apotex Corp. (2023). SIROLIMUS solution [package insert]. DailyMed.

                          Crow, S. (n.d.). What you need to know post-transplant: Common nutrient and herbal interactions. National Kidney Foundation.

                          View All References (5)

                          Li, J., et al. (2014). Rapamycin: One drug, many effects. Cell Metabolism. 

                          MedlinePlus. (2021). Transplant rejection.

                          MedlinePlus. (n.d.). Lymphangioleiomyomatosis.

                          Safarini, O. A., et al. (2022). Calcineurin inhibitors. StatPearls.

                          Zydus Pharmaceuticals USA Inc. (2023). SIROLIMUS tablet, film coated [package insert]. DailyMed.

                          GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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