Drugs Home > Sirolimus Dosage
In people who have a low risk of transplant rejection, sirolimus is usually started at a one-time dose of 6 mg, followed by a daily dose of 2 mg thereafter. The maximum daily dose is 40 mg. This medication comes in the form of a tablet or an oral solution (liquid); if you are unable to swallow tablets, the liquid form may be a better choice.
The dose of sirolimus (Rapamune®) your healthcare provider recommends will vary, depending on a number of factors, including:
- Your weight
- Your blood levels of sirolimus
- Your risk for transplant rejection
- Other medical conditions you may have
- Other medications you are taking.
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
The usual sirolimus dose for preventing kidney transplant rejection in people with low rejection risk is a one-time initial dose of 6 mg (called a loading dose), followed by 2 mg each day thereafter (called the maintenance dose). Children 13 years and older who weigh less than 40 kilograms (88 pounds) will be given a loading dose and daily dose based on their "body surface area," which is normally calculated using the child's height and weight.
The usual dosage of sirolimus for preventing kidney transplant rejection in people with high rejection risk is a loading dose of up to 15 mg, followed by a maintenance dose of 5 mg each day thereafter. People who weigh less than 40 kilograms (88 pounds) will be given a loading dose and daily dose based on their "body surface area," which is normally calculated using height and weight.
Your healthcare provider will measure your blood level of sirolimus using a simple blood test. He or she will adjust your dose, if needed, to keep your blood levels within the recommended range. This amount may also be adjusted if you experience side effects or show signs of transplant rejection. The maximum recommended daily dose is sirolimus 40 mg per day.
People with liver disease will be given a lower maintenance dose. However, the loading amount will usually not change.
Sirolimus is normally initially used in combination with cyclosporine (Gengraf®, Neoral®, Sandimmune®) and a corticosteroid (such as prednisone). However, cyclosporine will usually be slowly reduced and stopped 2 to 4 months after the transplant surgery in people with low risk for transplant rejection, and 12 months after surgery in people with high risk.