If you’ve had a kidney transplant or have a certain type of lung condition, your doctor might suggest Rapamune as a treatment option for you.

Rapamune is a prescription drug used to prevent kidney transplant rejection in adults and certain children. It’s also used to treat a lung condition called lymphangioleiomyomatosis (LAM) in adults. LAM causes abnormal cells to grow in the lungs, making it harder to breathe. The condition also affects other parts of the body, including the kidneys and lymphatic system.

The active ingredient in Rapamune is sirolimus. (An active ingredient is what makes a drug work.)

It belongs to a group of drugs called mammalian target of rapamycin (mTOR) inhibitors.

Rapamune comes as a tablet and a liquid solution, both of which you swallow.

This article describes the dosages of Rapamune, its strengths, and how to take it. To learn more about Rapamune, see this in-depth article.

Note: This article covers Rapamune’s usual dosages, which the drugmaker provides. But when taking Rapamune, always take the dosage your doctor prescribes.

The information below describes the usual dosages of Rapamune. Always follow your doctor’s instructions regarding the dosage prescribed for you.

What are the forms of Rapamune?

Rapamune comes in two forms: a liquid solution and a tablet, both of which you swallow.

What strengths does Rapamune come in?

Rapamune comes in different strengths.

The liquid solution comes in one strength of 1 milligram per milliliter (mg/mL) in a 60 mL bottle.

The tablets come in three strengths: 0.5 mg, 1 mg, and 2 mg.

What are the usual dosages of Rapamune?

Your doctor will prescribe a loading dose of Rapamune to prevent kidney transplant rejection. (A loading dose is a higher dose of Rapamune to allow the drug to start working quickly in your body.) After this dose, you’ll take a lower maintenance dose to manage your condition. (A maintenance dose is a lower dose of Rapamune that keeps a consistent amount of the drug in your body.)

The loading dose and maintenance dose of Rapamune that your doctor prescribes to prevent kidney transplant rejection will depend on your condition and other factors.

The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for helping prevent kidney transplant rejection

The dosage of Rapamune to help prevent kidney transplant rejection depends on individual risk factors.*

For those with mild to moderate risk of kidney rejection, the usual loading dose is 6 mg on the first day of treatment. This is followed by a maintenance dose of 2 mg taken once per day.

For those with a high risk of kidney rejection, the usual loading dose is up to 15 mg on the first day. This is followed by a maintenance dose of 5 mg taken once per day.

*Studies have shown age, gender, race, immune compatibility, and other factors influence organ rejection and who is at high risk. Your doctor can provide more information about your individual risk factors.

Dosage for treating lymphangioleiomyomatosis (LAM)

The usual starting dosage of Rapamune for treating LAM is 2 mg, taken once daily. Your doctor will order regular blood tests to monitor the level of the drug in your blood for as long as you take it. They’ll adjust your dosage as needed to keep a consistent level of Rapamune in your system.

What’s the dosage of Rapamune for children?

Rapamune is used to prevent kidney transplant rejection in children ages 13 years and older who are at low to moderate risk. Your child’s doctor will likely start with a loading dose (higher dose) of Rapamune to help the drug work quickly in their body. After this, their doctor will prescribe a lower daily maintenance dose to keep steady levels of the drug in their system.

A child’s dose of Rapamune is based on their body weight and, sometimes, body surface area. The child’s doctor will calculate this using an equation that includes the child’s height and weight. The number is given in meters squared (m2).

Children weighing less than 40 kilograms (kg)

The loading dose for children weighing less than 40 kg* is 3 mg per m2 (body surface area). The maintenance dose is usually 1 mg per m2 daily. The doctor will adjust this regularly over time as the child grows.

Children weighing 40 kg or more

The loading dose for children weighing 40 kg* or more is up to 6 mg on the first day, followed by a maintenance dose of 2 mg once daily.

*1 kg equals about 2.2 pounds (lb).

Is Rapamune used long term?

Yes, Rapamune is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term. Your doctor can provide more information on how long you’re likely to take this drug based on your condition.

Dosage adjustments

In certain situations, your doctor may need to adjust your dosage of Rapamune. These include:

  • If you have liver problems, your doctor may lower your maintenance dose of Rapamune.
    • If you have mild to moderate liver disease, they’ll likely lower your dose by 1/3.
    • If you have severe liver disease, they’ll likely lower it by 1/2.
  • If your child weighs less than 40 kg, their doctor will calculate their Rapamune dosage based on their body surface area. The doctor will then adjust the child’s dose as they grow.
  • Your maintenance dosage may need to be adjusted from time to time based on blood test results. This is to keep a consistent level of Rapamune in your body.

If you have questions about your dosage of Rapamune, ask your doctor for more details.

The dosage of Rapamune your doctor prescribes may depend on several factors. These include:

  • the type and severity of the condition Rapamune is being used to treat
  • your age and body weight
  • the form of Rapamune you’re using
  • other factors, such as health conditions you may have (see “Dosage adjustments” just above)

Rapamune comes in two forms: a liquid solution and a tablet, both of which you swallow. Always take your dosage exactly as your doctor prescribes.

Do not crush, split, or chew Rapamune tablets. If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also ask your doctor about Rapamune liquid solution if you have trouble swallowing pills.

If your doctor prescribes Rapamune liquid solution, you’ll need to dilute it with orange juice or water before drinking your dose. You can learn more about how to take Rapamune liquid solution here.

Your doctor can recommend the form of Rapamune that’s best for you.

Do not take Rapamune with grapefruit or grapefruit juice. These can increase the level of Rapamune in your blood, which increases your risk of side effects.

You will take Rapamune once daily, with or without food. Try to take your dose around the same time every day to keep a constant level of the drug in your body.

If you take cyclosporine with Rapamune, be sure to take Rapamune at least 4 hours before or after your cyclosporine dose.

For information on the expiration, storage, and disposal of Rapamune, see this article.

Accessible drug containers and labels

If you find it hard to read the prescription label on your medication, tell your doctor or pharmacist. Some pharmacies provide medication labels that:

  • have large print or use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

If you have trouble opening medication bottles, let your pharmacist know. They may be able to supply Rapamune in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.

If it’s been less than 12 hours since your missed dose, take your dose of Rapamune. If it’s been more than 12 hours since you were supposed to take your dose, ask your doctor. They’ll tell you if it is safe to miss or skip the dose. Do not take two doses of Rapamune at once, or any extra doses to make up for a missed dose.

If you also take cyclosporine, do not take Rapamune at the same time. Be sure to separate your Rapamune dose from your cyclosporine dose by at least 4 hours.

If you need help remembering to take your dose of Rapamune on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.

Do not take more Rapamune than your doctor prescribes, as this can lead to serious side effects.

What to do in case you take too much Rapamune

Call your doctor right away if you think you’ve taken too much Rapamune. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

The sections above describe the usual dosages provided by the drugmaker. If your doctor recommends Rapamune for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Rapamune without your doctor’s recommendation. Only take Rapamune exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage. Here are some examples of questions you may want to ask:

  • How often will I need blood tests to determine if my dose of Rapamune needs to be adjusted?
  • Does my age affect my dose of Rapamune?
  • Could my dose of Rapamune affect my cholesterol levels?

To learn more about Rapamune, see these articles:

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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.