Major
Everolimus × Rifampicin
mTOR kinase inhibitor – immunosuppressant and antineoplastic×Antituberculous antibiotic
Mechanism
Rifampicin is a strong CYP3A4 inducer. Everolimus falls 60% – transplant rejection risk.
Symptoms
Transplant rejection signs.
Management
Alternative TB regimen without rifampicin. If necessary – double everolimus with frequent blood level monitoring.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- EMA: Certican (everolimus) SmPC (2024)– EMA EPAR Certican