Posaconazole and Sirolimus: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Posaconazole and Sirolimus unless specifically directed by your doctor.
How Posaconazole interacts with Sirolimus
Posaconazole strongly inhibits CYP3A4 and P-glycoprotein, which are key pathways for sirolimus clearance. Sirolimus concentrations can rise markedly, increasing risk of nephrotoxicity, cytopenias, hyperlipidemia, and other toxicities.
What you should do
Avoid the combination unless specialist monitoring is available. If unavoidable, make a major sirolimus dose reduction and monitor trough concentrations frequently.
Key facts
Severity
Major — avoid combination
Mechanism
Posaconazole strongly inhibits CYP3A4 and P-glycoprotein, which are key pathways for sirolimus clearance. Sirolimus conc...
Action
Avoid the combination unless specialist monitoring is available. If unavoidable, make a major sirolimus dose reduction a...
Frequently asked questions
Can I take Posaconazole and Sirolimus together?
No — this combination should generally be avoided. Avoid the combination unless specialist monitoring is available. If unavoidable, make a major sirolimus dose reduction and monitor trough concentrations frequently.
What is the severity of this interaction?
The interaction between Posaconazole and Sirolimus is classified as Major — avoid combination. Posaconazole strongly inhibits CYP3A4 and P-glycoprotein, which are key pathways for sirolimus clearance. Sirolimus concentrations can rise markedly, increasing risk of nephrotoxicity, cytopenias, hyperlipidemia, and other toxicities.
What should I do if I'm prescribed both?
Avoid the combination unless specialist monitoring is available. If unavoidable, make a major sirolimus dose reduction and monitor trough concentrations frequently. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.