Sirolimus
Sirolimus is an immunosuppressant taken once daily after a kidney transplant and in the rare lung condition LAM, sold as Rapamycin 1mg tablets.
What sirolimus is used for
Sirolimus is an immunosuppressant: it holds back the immune system so that it does not attack a transplanted organ. Adults at low to moderate immune risk take it after a kidney transplant, usually alongside ciclosporin and steroids for the first two to three months and then as maintenance treatment. It also has a place in lymphangioleiomyomatosis (LAM), a rare lung disease in which unusual muscle-like cells grow through the air spaces and make breathing harder.
How sirolimus works
A transplanted kidney is attacked by T-lymphocytes, white cells that multiply when a protein called mTOR tells them to. Sirolimus blocks mTOR, so they stop dividing.
One tablet does not act within minutes. The effect builds over several days of regular dosing, so sirolimus is a daily medicine and there is no point waiting for a problem before taking it.
The sirolimus tablets we sell
Rapamycin 1mg coated tablets are the sirolimus product sold here. The daily number of tablets is not the same for everyone: the amount is set from levels measured in the blood during treatment, so two people taking the same tablet may take a different number each day.
Taking sirolimus
The routine is one dose daily at a fixed hour. Whether that is with breakfast or before it matters less than not switching between the two, because food changes how much is absorbed. Grapefruit and grapefruit juice slow the breakdown of sirolimus and can push blood levels too high, so leave them out. St John's wort does the opposite and can leave too little of the medicine in the body. Live vaccines are not given during treatment, because a damped-down immune system cannot respond to them properly.
Side effects and what to watch for
Mouth ulcers are the complaint people notice first, often within the opening weeks. Diarrhoea, acne, rash, swollen ankles, raised cholesterol and triglycerides, high blood pressure and low red cell and platelet counts are also common. With the immune system damped down, infections are more frequent and can be severe. Less often, sirolimus inflames the lung tissue, damages the kidneys, encourages blood clots and slows wound healing, and years of treatment raise the risk of skin cancer and lymphoma. A fever with shivering and feeling very unwell, or sudden breathlessness, needs urgent treatment.
Sources
- Rapamune 1mg coated tablets - Summary of Product Characteristics (SmPC) - (emc) — electronic medicines compendium (emc) / Pfizer Limited
- Immunosuppressants (Anti-rejection Medicines) — National Kidney Foundation
Where can I order Sirolimus for delivery in Hong Kong?
Sirolimus can be ordered online with delivery to Hong Kong. The page lists generic Rapamycin tablets in 1mg. Every order ships in plain, unbranded packaging with nothing on the outside about the contents.
How much do Sirolimus products cost in Hong Kong?
The price depends on the strength and pack size you choose. The Rapamycin page shows current prices in HKD or the currency you select.
Does PockDose sell generic Rapamycin?
Yes, generic Rapamycin is listed as tablets in 1mg and contains sirolimus. It is the only sirolimus product shown here, so there is no separate plain sirolimus version or other named version on this page.
What are the brand names for sirolimus?
Sirolimus is sold under brand names including Rapamune and Hyftor. Here, sirolimus can be bought online as Rapamycin. These are generics, not the original brand.
How is sirolimus taken?
One tablet daily, at a fixed hour, swallowed with a glass of water. Food alters how much sirolimus is absorbed, so choose either with meals or away from them and keep to it; that keeps the blood level steady from one day to the next.
Can I drink grapefruit juice with sirolimus?
No — grapefruit and grapefruit juice slow the body's breakdown of sirolimus, so more of it stays in the blood than intended. Grapefruit segments in a fruit salad count too. St John's wort has the opposite effect and can leave the medicine too weak.
What are the most common side effects of sirolimus?
Mouth ulcers are the most common and usually show up in the first few weeks. Diarrhoea, acne, rash, swollen ankles, raised cholesterol and triglycerides, and low blood counts are also frequent. Infections happen more easily because the immune system is held back.
How long do people take sirolimus?
After a kidney transplant it is usually maintenance treatment taken for years rather than a short course. In lymphangioleiomyomatosis it is also a long-term medicine, not something taken for a few weeks.
What is lymphangioleiomyomatosis?
A rare lung disease in which unusual muscle-like cells grow into the air spaces and form cysts, making breathing harder. It affects women almost exclusively. Sirolimus is used for the form that causes moderate lung disease or declining lung function.