Sirolimus

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Sirolimus

Examples of brand names: Rapamune [EU/DE]

ATC code: L04AH01

Main use (for orientation): Transplant medicine

Documented research summary

A TSC patient series shows increased sirolimus trough concentrations with CBD (CL23). Do not transfer oral findings to albumin-bound intravenous sirolimus. Social-media THC reports are unverified signals. Oral SPL sections 5.21/7.5 explicitly name CBD as a possible cause of increased sirolimus concentrations and call for close concentration monitoring.

Uncertainties and limitations

CBD patient series without randomisation; therapeutic drug monitoring and dose adjustments. Do not extrapolate to intravenous sirolimus.

Separately recorded findings

3 separately recorded findings. Each statement applies to its documented study context.

CBD – clinical signals

Finding ID: B0081

Type of result: Positive finding / indication

Observation: Median trough-concentration increase +5.1 ng/ml.

Mechanism: Mechanism not established

Study type: Retrospective case series

Context studied: Same series of 25 people in total; sirolimus subgroup n=7.

Clinical interpretation: Potentially high

Limitations and uncertainties: Not an independent overall sample.

Original sources for this finding: Cannabidiol Elevates Mechanistic Target of Rapamycin Inhibitor Levels in Patients With Tuberous Sclerosis Complex [CL23]

CBD – laboratory and animal studies

Finding ID: B0435

Type of result: Preclinical endpoint

Observation: The combination altered viability endpoints and showed faster wound closure in senescent fibroblasts; different endpoints do not produce a uniform benefit/risk signal.

Mechanism: Additional pharmacodynamic cell endpoint; rapamycin/sirolimus combined with CBD, separate from known clinical trough-concentration findings.

Study type: Original in vitro study

Context studied: CCD-1064Sk cells; rapamycin 5 µM and CBD 2 µM; MTT, neutral-red and scratch assays.

Clinical interpretation: Clinical significance unresolved

Limitations and uncertainties: No conclusion about clinical transplantation safety. Not a duplicate of the existing sirolimus–CBD case-series finding B0081; different experiment and endpoint.

Original sources for this finding: The Effects of Nutrient Signaling Regulators in Combination with Phytocannabinoids on the Senescence-Associated Phenotype in Human Dermal Fibroblasts. [VD_MED_35955938]

THC – laboratory and animal studies

Finding ID: B0436

Type of result: Preclinical endpoint

Observation: Reduced viability/neutral-red endpoints observed with the combination; no reliable general regenerative effect can be inferred.

Mechanism: Additional pharmacodynamic cell endpoint with rapamycin/sirolimus and THC; no pharmacokinetic evidence.

Study type: Original in vitro study

Context studied: CCD-1064Sk cells, healthy/stress-induced senescent; rapamycin 5 µM and THC 2 µM.

Clinical interpretation: Clinical significance unresolved

Limitations and uncertainties: Cell experiment, not clinical immunosuppression, trough-concentration or dosage information. Do not equate changes versus vehicle with pharmacological synergy.

Original sources for this finding: The Effects of Nutrient Signaling Regulators in Combination with Phytocannabinoids on the Senescence-Associated Phenotype in Human Dermal Fibroblasts. [VD_MED_35955938]

References and access status

[CA_L_D0021] SIROLIMUS SOLUTION [MYLAN PHARMACEUTICALS INC.]

Original source / bibliographic reference

Authors: Mylan Pharmaceuticals Inc.

Year: 2026

Source type: Current published human-use SPL / product information

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[CL23] Cannabidiol Elevates Mechanistic Target of Rapamycin Inhibitor Levels in Patients With Tuberous Sclerosis Complex

Original source / bibliographic reference

Authors: Ebrahimi-Fakhari D; Agricola KD; Tudor C; Krueger D; Franz DN

Year: 2020

Source type: Retrospective case series

DOI: 10.1016/j.pediatrneurol.2019.11.017

PMID: 31924480

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[VD_MED_35955938] The Effects of Nutrient Signaling Regulators in Combination with Phytocannabinoids on the Senescence-Associated Phenotype in Human Dermal Fibroblasts.

Original source / bibliographic reference

Authors: Gerasymchuk M, Robinson GI, Kovalchuk O, Kovalchuk I.

Year: 2022

Source type: research-article; Journal Article

DOI: 10.3390/ijms23158804

PMID: 35955938

Source access – 23 October 2026: Automated direct retrieval was restricted; this does not establish that the link is broken.

Bibliographic attribution or source identity cross-checked.

PubMed – bibliographic reference / abstract

PubMed Central – full-text access according to the literature database – Archive attribution confirmed by Europe PMC metadata. Direct retrieval was not fully verified here; access may require a browser check.

Europe PMC – full-text access according to the literature database – Listed as freely available HTML full text in the official Europe PMC metadata. Direct retrieval was not fully verified here.

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility