Siroboon (Sirolimus)

Siroboon is Kachhela Medex's sirolimus tablet, in a strip of 10 tablets. Sirolimus (rapamycin) is an immunosuppressant that blocks the mTOR protein, used to prevent organ rejection and in a few rare diseases.

Sirolimus is prescribed to prevent rejection after a kidney transplant and for lymphangioleiomyomatosis (LAM). In some countries, it is also used in drug-coated heart stents and for certain tumours. Its use for slowing ageing is under study only and is not approved.

Sirolimus binds the protein FKBP12 and blocks mTOR, a pathway that tells cells to grow and divide, including the immune T cells that attack a transplant. Switching that pathway down also slows cell growth in some tumours and in the lining of arteries.

It is taken once a day by mouth, at the same time every day, either always with food or always without. Blood levels are checked to set the dose, so follow your transplant doctor's instructions closely. Do not stop it suddenly.

• Mouth ulcers, swelling and fluid retention.
• Raised cholesterol and triglycerides.
• Low blood counts and a higher risk of infection.
• Slower wound healing.
• Raised blood sugar, rash, acne, diarrhoea and joint pain.
• Rarely, lung inflammation, kidney problems and a higher risk of skin cancer or lymphoma with long immunosuppression.

Not for pregnancy, and contraception is needed during and after treatment. Avoid live vaccines, grapefruit juice and strong CYP3A4 inhibitors or inducers (ketoconazole, rifampicin, St John's wort). It needs regular blood tests, lipid checks and skin checks, and it is a specialist medicine taken only under medical supervision.