Drug Interactions

Potential Drug Interactions with TORISEL¹

• TORISEL can be metabolized by the CYP3A4 isoenzyme
• Strong CYP3A4 inducers may reduce exposure to the major metabolite of TORISEL and should be avoided
  • If patients must be co-administered a strong CYP3A4 inducer, based on pharmacokinetic studies, a TORISEL dose increase from 25 mg/week up to 50 mg/week should be considered
  • Strong CYP3A4 inducers include but are not limited to dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifampacin, and phenobarbital
  • St. John’s Wort should not be taken concomitantly with TORISEL
• Strong CYP3A4 inhibitors may increase blood concentrations of the major metabolite of TORISEL and should be avoided
• If patients must be co-administered a strong CYP3A4 inhibitor, based on pharmacokinetic studies, a TORISEL dose reduction to 12.5 mg/week should be considered
• If the strong inhibitor is discontinued, a washout period of approximately 1 week should be allowed before the TORISEL dose is adjusted back to the dose used prior to initiation of the strong CYP3A4 inhibitor
• Grapefruit juice may also increase plasma concentrations of sirolimus (a major metabolite of temsirolimus) and should be avoided
• Strong CYP3A4 inhibitors include but are not limited to ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, and voriconazole

For more detailed information, download the Drug Interaction Reference Guide for TORISEL. (Adobe^® PDF)

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