Rapamune Oral Solution (Sirolimus)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Rapamune Oral Solution Used For?
Rapamune Oral Solution contains sirolimus, an immunosuppressant medication that helps control your body’s immune system after receiving an organ transplant.
Primary Uses
Rapamune is used to prevent your body from rejecting a transplanted kidney. It is not recommended for patients who have received liver or lung transplants.
How It Works
Rapamune belongs to a group of medicines called immunosuppressants that help control your body’s immune system to prevent organ rejection.
Good to know: Rapamune is not habit-forming.
How to Take Rapamune Oral Solution
Always take Rapamune exactly as your doctor tells you. The medication requires careful preparation and should be taken consistently at the same time each day.
Dosage Instructions
The usual starting dose is 6 mg after transplantation, then 2 mg once daily. You will also take other medicines like ciclosporin and corticosteroids initially. After 2-4 months, your doctor will reduce ciclosporin and increase Rapamune until ciclosporin is completely stopped. Take consistently with or without food, but never with grapefruit juice. If taking ciclosporin, take Rapamune 4 hours after your ciclosporin dose. Follow detailed preparation instructions using the provided syringe and dilute in at least 60 mL of water or orange juice.
What If You Miss a Dose?
If it’s almost time for your next dose (within 4 hours), skip the missed dose and take your next dose as scheduled. Otherwise, take it as soon as you remember, then return to your normal schedule. Always keep Rapamune and ciclosporin approximately 4 hours apart.
Important: Never take a double dose to make up for a missed dose. You will need to take Rapamune for the rest of your life or until your doctor changes your medication.
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- burning sensation during urination or increased urgency
- increased thirst and hunger
- fluid-filled skin swelling
- abnormal wound healing
- fast heartbeat
- pain
- diarrhea
- mouth ulcers and cold sores
- nosebleed
- pneumonia
- acne
- rash
- fever
- headache
- constipation
- nausea
- ovarian cyst symptoms
- changes in menstrual bleeding patterns
Seek immediate medical attention if you experience:
- signs of allergic reaction (rash, itching, hives, swelling, breathing problems)
- excessive fluid on lungs (coughing, difficulty breathing, wheezing)
- swelling of hands, feet, limbs, abdomen, or around eyes
- constant flu-like symptoms or signs of infection
- new lumps, spots, moles, or changes to existing ones
- blood disorder signs (tiredness, headaches, shortness of breath, dizziness, paleness, unusual bleeding)
- blood clot signs (severe headache, loss of coordination, vision problems, speech problems, numbness, leg swelling, chest pain, coughing blood)
- neurological disorder signs (headache, confusion, seizures, visual disturbances)
Important Warnings
There are several important warnings and precautions to be aware of before taking Rapamune.
Who Should Not Take Rapamune Oral Solution
Do not take Rapamune if you have an allergy to sirolimus or any ingredients in the medication. Symptoms of allergic reaction include wheezing, shortness of breath, difficulty breathing, tight chest feeling, swelling of face/lips/tongue, rash, itching, hives, flushed skin, dizziness, or light-headedness.
Medical Conditions to Discuss
Tell your doctor if you have liver problems or disease affecting your liver, high fat levels in blood, or rhabdomyolysis (a condition causing muscle weakness, tenderness, and temporary paralysis).
Pregnancy and Breastfeeding
Rapamune is not recommended during pregnancy or breastfeeding. Women must use effective contraception before starting treatment and continue for 12 weeks after stopping. It’s unknown if Rapamune passes into breast milk.
Cancer Risk: Immunosuppressive medicines like Rapamune may increase the risk of developing lymph gland and skin cancers. Report any new lumps, spots, moles, or changes to existing ones immediately.
Drug Interactions
Many medicines can interfere with Rapamune and affect how it works. Always tell your doctor about all medications you’re taking.
Grapefruit interaction: Do not take Rapamune with grapefruit juice.
- ciclosporin (used to prevent transplant rejection)
- antibiotics (rifampicin, clarithromycin, erythromycin, rifabutin)
- antifungal medicines (ketoconazole, clotrimazole, fluconazole, voriconazole, itraconazole)
- blood pressure/heart medicines (diltiazem, verapamil)
- epilepsy medicines (carbamazepine, phenobarbitone, phenytoin)
- stomach ulcer/reflux medicines (cimetidine, cisapride)
- anti-nausea medicines (metoclopramide)
- danazol (for endometriosis)
- bromocriptine (for Parkinson’s disease)
- letermovir (prevents CMV after bone marrow transplant)
- protease inhibitors (ritonavir, boceprevir, telaprevir, indinavir)
- ACE inhibitors (perindopril, ramipril)
- cannabidiol (for epilepsy and chronic pain)
- St. John’s wort
Alcohol & Driving
Be cautious with activities requiring alertness and take sun protection measures while using Rapamune.
Alcohol
No specific alcohol warnings mentioned in the source material.
Driving and Operating Machinery
Be careful before driving or using machines or tools until you know how Rapamune affects you.
Sun Protection
Limit exposure to sunlight and UV light by wearing protective clothing and using sunscreen with high protection factor, as immunosuppressive medicines may increase skin cancer risk.
Storage
Keep Rapamune in its original container, protected from light, in a refrigerator at 2-8°C. Once opened, keep refrigerated and use within one month. Discard syringes after single use. Keep away from children. When refrigerated, the solution may separate or appear hazy – bring to room temperature and shake gently if this occurs.
Overdose Information
If you think you have taken too much Rapamune, seek urgent medical attention immediately. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital Emergency Department, even if you feel fine. Taking too much Rapamune may cause abnormal heart rhythm.
Frequently Asked Questions
Rapamune begins working immediately to suppress your immune system and prevent organ rejection. Your doctor will monitor blood levels to ensure the medication is working effectively.
Yes, you can take Rapamune consistently either with or without food. However, never take it with grapefruit juice as this can interfere with the medication.
No, Rapamune is not habit-forming or addictive.
Never stop taking Rapamune without checking with your doctor first. Kidney transplant patients need to remain on immunosuppressive medication indefinitely to prevent organ rejection.
Use the provided syringe to withdraw your prescribed dose, then empty it into at least 60 mL of water or orange juice, stir for one minute, and drink immediately. Rinse the cup with another 120 mL of water or orange juice and drink that too.
If it’s within 4 hours of your next dose, skip the missed dose. Otherwise, take it as soon as you remember. Never double dose, and always keep Rapamune and ciclosporin about 4 hours apart.
Tell your doctor you’re taking Rapamune before any vaccination, as it may affect your response to vaccines.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.