SiroBoon 1 mg

The main benefit in kidney transplant care is helping protect the transplanted kidney from rejection. Sirolimus forms part of a specialist plan rather than replacing the whole transplant regimen.

Treatment goals include the following.

• Controlling the immune response against a transplanted kidney

• Supporting an individual long term transplant treatment plan

• Helping stabilise lung function in suitable patients with LAM

• Providing a 1 mg tablet strength for the prescribed dose

Good treatment results depend on consistent use and monitoring. Feeling well does not mean that transplant medicines are no longer needed.

Sirolimus acts on a protein pathway called mTOR. This pathway helps regulate cell growth and division. The medicine binds to a protein inside cells and the resulting complex inhibits mTOR activity.

In transplant care this reduces the growth and activation of certain immune cells. The effect helps limit the immune attack on the transplanted kidney.

In LAM the same pathway is involved in abnormal cell growth. Blocking it helps control the disease process and supports treatment aimed at stabilising lung function.

Reducing immune activity also lowers the body's ability to fight infections. This explains why blood tests and prompt reporting of illness are essential parts of treatment.

Take SiroBoon 1 mg exactly as prescribed. Sirolimus is generally taken once daily at a consistent time. The dose depends on the condition being treated and the blood concentration needed for your individual plan.

Kidney transplant treatment sometimes begins with a loading dose followed by a maintenance dose. The amount depends on rejection risk and the other medicines used. Your transplant team should provide the complete schedule. Do not calculate it from the 1 mg tablet strength.

For LAM a commonly recommended initial sirolimus dose is 2 mg daily. The specialist then adjusts treatment using blood levels and the clinical response.

Swallow sirolimus tablets whole with water. Do not split or crush them. Do not chew them. Take the medicine consistently with food or consistently without food because changes in food intake affect absorption.

If your regimen includes cyclosporine, sirolimus is generally taken four hours after it. Follow the exact timing provided by your transplant team. Do not stop or change either medicine yourself.

If you miss a dose follow the instructions in your leaflet or contact the treatment team. Do not double the dose. Seek urgent advice if you take more than prescribed. Do not switch tablet brands or change between tablets and liquid without your specialist's agreement.

Common Side Effects: SiroBoon 1 mg can cause swelling in the hands or feet, mouth sores, nausea, diarrhoea, abdominal discomfort, headache, acne, rash, joint pain, fever and tiredness. Blood tests can also show increased cholesterol or triglycerides, reduced haemoglobin, fewer platelets or changes in kidney function. Persistent or troublesome effects require medical review.

Serious Side Effects: Contact the transplant team immediately for fever, chills, a persistent cough, difficulty breathing, unusual bleeding, severe weakness, slow wound healing or increasing swelling. Urgent medical help is required for swelling of the face or throat, chest pain, fainting, severe breathing difficulty or a widespread peeling rash. Sirolimus suppresses immune function and increases susceptibility to serious infections. Long-term immunosuppression also increases the risk of lymphoma and skin cancer.

Do not take SiroBoon if you are allergic to sirolimus or another ingredient in the tablet. Treatment requires specialist assessment and is unsuitable for self medication. Tell your specialist before treatment if any of the following applies.

• An active infection or recent serious infection

• Liver disease

• High cholesterol or triglycerides

• Low blood cell counts or unexplained bleeding

• A poorly healing wound or planned surgery

• Pregnancy or plans to become pregnant

• Breastfeeding

• Previous cancer or concerning skin changes

Sirolimus is not recommended for prevention of liver or lung transplant rejection. Age eligibility also depends on the indication. Do not give the tablets to a child without specialist prescribing.

Use effective contraception during treatment and for 12 weeks after the final dose. Discuss breastfeeding with your specialist before treatment. Sirolimus also affects fertility in some patients. Ask about fertility plans before starting rather than stopping an established transplant regimen yourself.

Sirolimus levels change when certain medicines affect its breakdown or transport in the body. Both increased and reduced levels matter. Give your pharmacist a complete list of medicines and supplements before treatment and whenever something changes.

Important medicines and substances to discuss include the following.

• Cyclosporine and other transplant medicines

• Ketoconazole and itraconazole

• Clarithromycin and erythromycin

• Rifampicin and rifabutin

• Ritonavir and other interacting antiviral medicines

• Carbamazepine and phenytoin

• Verapamil and diltiazem

• Cannabidiol products

• St John's wort

• Grapefruit and grapefruit juice

• Live vaccines

Avoid grapefruit because it alters sirolimus exposure. Do not use St John's wort. Strong enzyme inhibitors or inducers generally need an alternative medicine or a specialist treatment decision.

Live vaccines should be avoided during sirolimus treatment. Ask your treatment team about vaccine planning. Do not stop prescribed medicines yourself to manage an interaction. A pharmacist should check new antibiotics and treatments bought without a prescription before you take them.

Follow the storage directions on your supplied packaging. The reviewed SiroBoon pack states storage below 25 degrees Celsius in a dry place with protection from light.

• Keep tablets in their original packaging until use

• Protect the pack from moisture and direct light

• Keep out of the reach and sight of children

• Check the expiry date before use

• Do not use tablets from damaged packaging

• Ask a pharmacist how to dispose of unwanted or expired medicine