Rapamune 1mg

Rapamune general information

What is Rapamune used for?

Rapamune tablets 1mg are used to help prevent organ rejection of a transplanted kidney, which is the last resort treatment for kidney failure. 

The kidneys lie towards your back and on each side of your spine.  They are vital organs for many body functions, and kidney failure is a life-threatening condition.  The main job performed by the kidneys is to remove toxins from the blood, filter out waste products of metabolism like urea and creatinine, and remove excess fluids, turning them into urine to be excreted.  The kidneys also keep a constant balance in the electrolyte and water content of your body fluids by regulating essential ions in the blood and urine like calcium, sodium, and potassium.  The kidneys produce several hormones.  Renin regulates salt and water balance, which helps control blood pressure.  Erythropoietin stimulates the bone marrow to make red blood cells.  Calcitriol, also known as Vitamin D regulates calcium levels and supports strong bones. 

Kidney failure

If the function of the kidneys is impaired in any way, this can lead to kidney disease and ultimately kidney failure.  Kidney failure or end-stage renal failure is when most of your kidney function has been lost.  It can develop quickly or over a long time due to chronic kidney disease.

The main causes of kidney failure are related to diabetes and high blood pressure, both of which cause damage to the kidney cells.  Other causes include conditions like glomerulonephritis, which is inflammation and damage to the filtering structures of the kidneys called the glomeruli.  Kidney stones, tumours and kidney infection can also cause kidney damage.  Also, family history and genetics are a factor in developing kidney disease. 

Symptoms of kidney failure include changes in amount and frequency of urination, blood in the urine, lethargy, loss of appetite, nausea, vomiting, puffiness and swelling of the ankles and legs (oedema), pain in the area of your kidneys, lack of concentration, shortness of breath, and high blood pressure.  The major cause of death if kidney failure cannot be resolved is heart disease.

Kidney transplant

Kidney failure cannot be cured but can be treated by dialysis, which is the process of filtering the blood by a dialysis machine.  If this does not work to restore kidney function, the only other choice is a kidney transplant.  It is essential to find a close match to your own tissue type to prevent the kidney transplant being rejected.  However, your immune system will attack any foreign cell, and even a close match may not prevent your immune cells from destroying the transplanted kidney.  Rapamune tablets 1mg are used to help prevent organ rejection of a transplanted kidney. 

How does Rapamune work?

Rapamune tablets 1mg contain sirolimus, also known as rapamycin, an immunosuppressant that is used to prevent organ rejection of a transplanted kidney.  An immunosuppressant drug works by interacting with cells of the immune system to reduce and weaken the immune response.  When the immune system recognises a cell as foreign, specific immune cells, are activated and proliferate.  T cells produce chemicals like interleukins that help progress the immune response, and B cells produce antibodies to destroy the foreign cells. 

T cell activation takes place in two stages.  Some immunosuppressant drugs like ciclosporin and tacrolimus block the first phase of T cell activation.  Sirolimus in Rapamune tablets 1mg blocks the second phase of T cell activation.  It first binds to a specific protein inside T cells called FKBP-12 forming a complex.  This complex blocks the activation of an enzyme called mammalian Target Of Rapamycin (mTOR).  mTOR is critical to the complex messaging process that takes place within the T cells and allows them to complete the activation process.  The action of sirolimus in Rapamune tablets 1mg blocks the replication of T cells and prevents them mounting an immune response against the transplanted kidney.

What does Rapamune contain?

Rapamune tablets 1mg contain the active ingredient sirolimus, an immunosuppressant used to prevent rejection of a transplanted kidney.  They also contain macrogol 20000, glyceryl mono-oleate, shellac, calcium sulphate, microcrystalline cellulose, sucrose, titanium dioxide, poloxamer 188, povidone, carnauba wax, DL-alpha tocopherol acetate, Opacode Red S-1-15095 ink.

What are the side effects of Rapamune?

Most medications have some side effects, but they are not experienced by everyone.  Some side effects are commonly experienced when taking Rapamune tablets 1mg, but others are not so common, and you should discuss any problems or concerns with your primary care physician. 

Common side effects when taking Rapamune include pneumonia and increased infections, non-melanoma skin cancers, anaemia and leukopenia (low white blood cells count), haemolytic uraemic syndrome (damage to small blood vessels in the kidneys and formation of blood clots), allergic and hypersensitivity reactions, headache, tachycardia (rapid heartbeat), high blood pressure, blood clot formation, gastrointestinal disorders (including constipation, diarrhoea, nausea, pancreatitis), skin rash, arthralgia (joint pain), menstrual disorders, fluid retention (oedema), protein in the urine.

When should Rapamune not be used?

Have a talk with your primary healthcare physician before taking Rapamune tablets 1mg so that you have a full understanding of what this medicine is for and how to use it.  There are some reasons for not taking a medication; these are called contraindications, and for Rapamune you should consider the following before taking Rapamune:

• Have you ever had an unusual reaction or an allergy when taking Rapamune?
• Are you pregnant or breastfeeding?
• Do you have any problems with your liver?
• Avoid having any vaccinations as Rapamune will reduce the effectiveness of the vaccine
• Do you have high cholesterol?
• Do you have a condition called rhabdomyolysis?

What medications interact with Rapamune?

Some medicines interact with Rapamune tablets 1mg and may affect the way it works, or are affected by Rapamune or increase side effects; you should discuss possible interactions with your primary care physician.  These may include antibiotics like rifampicin and erythromycin, antifungals like ketoconazole, calcium channel blockers like diltiazem and verapamil, anticonvulsants like carbamazepine and phenytoin, cimetidine and cisapride for reflux, the antiemetic metoclopramide, protease inhibitors for HIV like ritonavir, the herbal medicine St. John's wort.

If other medications may interact with Rapamune, your doctor will discuss these with you. 

How should Rapamune be taken and for how long?

You should take your Rapamune tablets 1mg swallowed whole with a glass of water with or without food, once daily at the same time each day.  You should start taking your Rapamune as soon as possible after transplantation.  The dose you take depends on how you respond and your doctor’s recommendation.  You will also be advised to take other immunosuppressants including ciclosporin and corticosteroids.  You should take your Rapamune tablets four hours after taking ciclosporin.  You should continue to take your Rapamune tablets for as long as recommended by your doctor, which may be for several months or longer.

Missed dose of Rapamune

If you miss a dose of Rapamune tablets 1mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Rapamune be stored?

You should store your Rapamune tablets 1mg below 25°C in a cool dry place.