Sirolimus

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Contents

Introduction

A macrolide isolated from Streptomyces hygroscopicus that acts via the mTOR pathway to selectively block the transcriptional activation of cytokines.

Clinical Use

Indications

Administration

Oral usually in range 2 to 6mg often adjusted with blood monitoring and taken diluted with water or orange juice

Clinical Issues

Contra-indications

  • Pregnancy
  • Breast feeding

Cautions and Interactions

Multiple interactions some of considerable importance such as with cyclosporin

Side effects

Multiple including hypersensitivity and immunosuppression

Special advice

Pharmacology

  • Suppresses mTOR signaling by binding to a class of proteins actually first defined by its binding activity. It may thus be active from animal models in reducing malignant transformation in tuberous sclerosis and in prolonging life span. It inhibits:

Sirolimus binds to serine/threonine-protein kinase mTOR, a key regulatory kinase which results in inhibition at the G1 to the S phase of the cell cycle suppressing cytokine-driven T-cell proliferation.

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