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Rapamune (sirolimus) is indicated for the prophylaxis of organ rejection in patients receiving renal transplants.
In patients at low to moderate immunologic risk, it is recommended that Rapamune be used initially in a regimen with cyclosporine and corticosteroids.
Cyclosporine should be withdrawn 2 to 4 months after transplantation and the Rapamune dose should be increased to reach recommended blood concentrations (see Dosage & Administration). Cyclosporine withdrawal has not been studied in patients with Banff 93 Grade III acute rejection or vascular rejection prior to cyclosporine withdrawal, those who are dialysis-dependent, or with serum creatinine >4.5 mg/dL, Black patients, renal re-transplants, multi-organ transplants, or patients with high-panel reactive antibodies (see Pharmacology: Pharmacodynamics: Clinical Trials Data on Efficacy under Actions).
