Clotrimazole and Sirolimus: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sirolimus
Clotrimazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of sirolimus toxicity (anemia, leukopenia, thrombocytopenia, hypokalemia, fever, diarrhea)
Interaction Deep Dive
Sirolimus is extensively metabolized by cytochrome P450 3A4 (CYP3A4) enzymes in the gut wall and liver. Drugs such as clotrimazole, which are cytochrome P450 inhibitors, may decrease the metabolism of sirolimus, causing increased sirolimus plasma concentrations. Caution should be used when these two agents are coadministered1.
Why it happens (mechanism)
Inhibition of cytochrome P450-mediated sirolimus metabolism
Common questions
Can I take Clotrimazole and Sirolimus together?
An increased risk of sirolimus toxicity (anemia, leukopenia, thrombocytopenia, hypokalemia, fever, diarrhea) Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clotrimazole and Sirolimus interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Clotrimazole or Sirolimus need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: Rapamune(R), sirolimus, oral solution and tablets. Wyeth Pharmaceuticals Inc. Philadelphia, PA, USA, 2005. DailyMed
Keep reading about Sirolimus
Keep reading about Clotrimazole
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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