Sirolimus tablets

What is this medication?

SIROLIMUS (sir OH li mus) is used to decrease the immune system's response to a transplanted organ. It is also used to treat a rare lung disease called lymphangioleiomyomatosis.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Rapamune

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• diabetes
• heart disease or heart failure
• high cholesterol or triglycerides
• infection
• liver disease
• an unusual or allergic reaction to sirolimus, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medication?

Take this medicine by mouth with a glass of water. Do not cut, crush or chew this medicine. Follow the directions on the prescription label. If you take the medicine with food, always take it with food. Do not take the medicine with grapefruit juice. If you are also taking cyclosporine, take this medicine at least 4 hours after taking your dose of cyclosporine. Take your medicine at regular intervals. You must take the medicine at the same time each day. Do not take your medicine more often than directed. Do not stop taking except on your doctor's advice.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 13 years of age for selected conditions, precautions do apply.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can, and call your doctor or health care professional. Call your doctor or health care professional if you vomit after a dose.

What may interact with this medication?

Do not take this medicine with any of the following medications:

• certain antibiotics like clarithromycin, erythromycin, telithromycin
• grapefruit juice
• medicines for fungal infections like itraconazole, ketoconazole, posaconazole, voriconazole
• mifepristone, RU-486
• rifabutin, rifampin

This medicine may also interact with the following medications:

• boceprevir
• bromocriptine
• carbamazepine
• cimetidine
• cisapride
• clotrimazole
• cyclosporine
• danazol
• diltiazem
• fluconazole
• indinavir
• metoclopramide
• nicardipine
• phenobarbital
• phenytoin
• rifapentine
• ritonavir
• St. John's wort
• telaprevir
• troleandomycin
• vaccines
• verapamil

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your doctor for regular checks on your progress. You will need frequent blood checks.

This medicine can cause your cholesterol or lipid levels to go up. You may need treatment for high cholesterol.

If you get a cold or other infection while receiving this medicine, call your doctor or health care professional. Do not treat yourself. The medicine may decrease your body's ability to fight infections.

This medicine may increase blood sugar. Ask your healthcare provider if changes in diet or medicines are needed if you have diabetes.

This medicine may increase your risk of getting some cancers. Talk with your doctor.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Women who are able to have children should use effective birth control before, during, and for 12 weeks after stopping this medicine.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• breathing problems
• chills, fever, sore throat
• dark urine
• fast, irregular heart beat
• feeling faint or lightheaded
• high blood pressure
• pinpoint red spots on the skin

signs and symptoms of high blood sugar such as being more thirsty or hungry or having to urinate more than normal. You may also feel very tired or have blurry vision.

• swelling, water retention
• trouble passing urine
• unusual bleeding or bruising
• unusually weak

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• aches, pain
• acne
• diarrhea
• nausea, vomiting
• stomach upset
• tremor
• trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.