Major
Isavuconazole × Sirolimus
Second-generation systemic triazole antifungal×Selective immunosuppressant, mTOR inhibitor
Mechanism
Isavuconazole is a moderate CYP3A4 inhibitor. Sirolimus rises 1.5-2 fold.
Symptoms
Nephrotoxicity.
Management
Reduce sirolimus by 50% with 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: Cresemba (isavuconazole) SmPC (2024)– EMA EPAR Cresemba