Afinitor (everolimus) is a prescription drug that’s used to treat some types of cancer, seizures, and certain tumors. This drug can interact with other medications and some supplements. For example, Afinitor can interact with certain antibiotics and antifungals.
Note: Afinitor comes as an oral tablet and as Afinitor Disperz, which is a tablet that’s mixed with water to form an oral suspension. The two forms have the same interactions. This article will use the term “Afinitor” to refer to both forms.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Before you start taking Afinitor, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Afinitor interacts with herbs or vitamins and supplements, see the “Are there other interactions with Afinitor?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Afinitor. Keep in mind that this table does not include all drugs that may interact with Afinitor. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| angiotensin-converting enzyme (ACE) inhibitors | • lisinopril (Zestril, Qbrelis) • ramipril (Altace) | can increase the risk of angioedema |
| certain antibiotics and antifungals | • clarithromycin • ketoconazole | can increase the risk of side effects from Afinitor |
| rifampin (Rimactane) | — | can make Afinitor less effective |
| antiepileptic medications | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) | can make Afinitor less effective |
| benzodiazepines | • alprazolam (Xanax) • diazepam (Valium) • midazolam | can increase the risk of side effects from benzodiazepines |
| medications that affect your immune system | • natalizumab (Tysabri) • tofacitinib (Xeljanz) • upadacitinib (Rinvoq) | can increase the risk of infection |
Certain health conditions or other factors could raise your risk of harm if you take Afinitor. In such cases, your doctor may not prescribe Afinitor for you. These are known as contraindications. Afinitor has one contraindication, which is described below.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Afinitor or any of its ingredients, your doctor likely won’t prescribe Afinitor for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Afinitor is not known to interact with alcohol. But Afinitor and alcohol can cause some similar side effects, such as diarrhea and fatigue. So you may be more likely to experience these side effects if you drink alcohol during your Afinitor treatment.
While using Afinitor, you should avoid using mouthwash that contains alcohol. Instead, use an alcohol-free mouthwash to reduce your risk of stomatitis (mouth sores), which is a side effect of Afinitor.
Afinitor is used to treat certain types of cancer, seizures, and certain tumors. If you have cancer, your doctor may suggest avoiding or limiting alcohol. Talk with your doctor to learn more.
If you have questions about consuming alcohol during your Afinitor treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Afinitor.
Interaction with certain antibiotics and antifungals
Afinitor can interact with certain antibiotics and antifungals.
Certain drugs block specific proteins made by your body to help break down or transport certain medications (including Afinitor). Examples of antibiotics and antifungals that do this include:
- clarithromycin
- ketoconazole
- itraconazole
- posaconazole
- ciprofloxacin
What could happen
Medications that block these proteins can increase the level of Afinitor in your system. Taking Afinitor with these medications can raise your risk of side effects of Afinitor, such as stomatitis (mouth sores) and infection.
What you can do
Because of the risk for side effects, doctors usually won’t prescribe Afinitor with certain antibiotics and antifungals. They can suggest alternatives to Afinitor or the other drug instead.
If you take Afinitor with a drug that moderately blocks certain proteins, your doctor may prescribe a lower dosage of Afinitor for you. You should not take a higher dose of either medication than your doctor prescribes.
If you have questions about taking Afinitor with other medications, talk with your doctor or pharmacist.
Interaction with benzodiazepines
Afinitor can interact with benzodiazepines, which are drugs that slow down your central nervous system (CNS).
Examples of benzodiazepines include:
- alprazolam
- diazepam
- midazolam
What could happen
Afinitor and benzodiazepines are both broken down by a specific protein in your body. But Afinitor can also block the action of this protein to some extent. Because of this, Afinitor could cause your body to break down the benzodiazepine more slowly than usual, which increases your risk of side effects.
What you can do
Before you start taking Afinitor, be sure to tell your doctor and pharmacist about all the medications you take. If you take a benzodiazepine, your doctor may prescribe a lower dose of that medication to reduce your risk of side effects.
Afinitor may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Afinitor.
Does Afinitor interact with supplements?
Before you start taking Afinitor, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Afinitor interactions with herbs
Afinitor can interact with St. John’s wort, which is used to ease symptoms of depression and to elevate mood.
St. John’s wort can speed up the action of certain proteins that affect how Afinitor is absorbed and broken down by your body. Because of this, St. John’s wort can decrease the level of Afinitor in your system, which can make it less effective.
Due to this interaction, your doctor may suggest you avoid taking St. John’s wort with Afinitor. Or, they may prescribe a higher Afinitor dosage for you. Be sure to talk with your doctor before taking St. John’s wort and Afinitor together.
Afinitor interactions with vitamins
There are currently no reports of Afinitor interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Afinitor.
Does Afinitor interact with food?
Afinitor can interact with grapefruit and grapefruit juice. Grapefruit products slow the action of certain proteins that affect how your body absorbs and breaks down Afinitor. This can raise the level of Afinitor in your system, which increases your risk of side effects from Afinitor.
As a result, your doctor may suggest that you don’t consume grapefruit and grapefruit juice while you’re taking Afinitor.
Does Afinitor interact with vaccines?
You should not receive live vaccines during your Afinitor treatment. (Live vaccines contain a weakened version of the bacteria or virus they’re meant to protect against.) This is because getting a live vaccine while you’re using Afinitor increases your risk of infection.
Examples of live vaccines include:
If you need to receive a vaccine during your Afinitor treatment, talk with your doctor first to make sure it’s safe.
Does Afinitor interact with lab tests?
Afinitor can interact with the purified protein derivative (PPD) skin test used to check for tuberculosis (TB).
Afinitor works by weakening your immune system. Medications that work in this way can affect the response to the PPD skin test, possibly causing a false negative. (With a false negative PPD skin test, the test shows you don’t have TB, even if TB is actually in your system.) This effect may continue for up to 6 weeks after your last dose of Afinitor.
If you need to receive a test for TB, be sure your doctor knows you’re taking Afinitor. They may prefer another test besides the PPD skin test.
Does Afinitor interact with cannabis or CBD?Cannabis(commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Afinitor.
Using cannabis can increase the level of Afinitor in your system. This raises your risk for side effects of Afinitor.
Before you start treatment with Afinitor, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Afinitor. Before taking Afinitor, talk with your doctor about your health history. They’ll help determine whether Afinitor is right for you.
Health conditions or other factors that might interact with Afinitor include:
Kidney condition: In rare cases, Afinitor can cause kidney failure. You may have a higher risk of this side effect if you already have a kidney condition, such as chronic kidney disease. In addition, taking Afinitor could worsen your condition. If you have a kidney condition, your doctor will likely monitor your kidney function during your Afinitor treatment.
Liver condition: If you have a liver condition such as cirrhosis, you may have a higher risk of side effects from Afinitor. This is because having liver problems can cause your body to break down Afinitor more slowly than usual, which increases the level of the drug in your system.
If you have a liver condition, your doctor may prescribe a lower dosage of Afinitor for you.
Diabetes: Afinitor may cause high blood sugar. If you have type 1 or type 2 diabetes, taking Afinitor could increase your blood sugar and worsen your diabetes. Your doctor can determine the best way to manage your diabetes if they prescribe Afinitor for you.
High blood cholesterol: Afinitor can increase the level of cholesterol in your blood. If you already have high cholesterol, Afinitor could worsen your condition. Your doctor can determine the best way to manage your high cholesterol if they prescribe Afinitor for you.
Current infection: Be sure to let your doctor know if you currently have an infection before you start taking Afinitor. Afinitor weakens your immune system, which may make it harder to treat an infection. Your doctor may want to treat your infection first before you begin Afinitor treatment.
Past hepatitis B: If you’ve previously had a hepatitis B virus (HBV) infection, taking Afinitor could reactivate the infection. “Reactivate” means the infection starts causing symptoms again. Hepatitis B reactivation can cause symptoms that are severe or even life-threatening. Your doctor will likely want to closely monitor you for HBV reactivation if they prescribe Afinitor.
Pregnancy: Afinitor may cause harm if used during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Afinitor.
Breastfeeding: Breastfeeding is not recommended while taking Afinitor and for at least 2 weeks after your last dose. It isn’t known whether the drug passes into breast milk or whether it could cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Afinitor or any of its ingredients, your doctor will likely not prescribe Afinitor. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Afinitor. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Afinitor treatment
It’s also important to understand Afinitor’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Afinitor exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.