Mouth ulcer sirolimus

The most common adverse events reported with sirolimus are leukopenia (20%), thrombocytopenia (13% to 30%), and hyperlipidemia (38% to 57%).11,31 Other adverse effects include delayed wound healing, anemia, diarrhea, arthralgias, rash, and mouth ulcers. Sirolimus has an FDA black-box warning in newly transplanted liver and lung recipients.11 In liver transplant recipients, use of sirolimus immediately after transplant is associated with an increased risk of hepatic artery thrombosis, graft loss, and death. In lung transplant... 

Mouth Mouth ulcers are common in patients who take sirolimus. In a study of the case notes of 37 renal transplant recipients who took sirolimus, eight had mouth ulcers [61 ]. Painful confluent aphthous ulcers on the tongue and lower lip in a 45-year-old man taking sirolimus 2 mg/day resolved when everolimus 0.75 mg bd was used instead [62" ]. 

Randomised controlled trial In a multinational phase 3b/4 study of sirolimus conversion in cardiac transplant recipients with renal insufficiency, the most common side effects noted were peripheral oedema 31.6%, diarrhoea 28.1%, rash 28.1%, dyspnoea 12.3%, abdominal pain 14%, aphthous stomatitis 14%, hypertension 12.3% and arthralgia, acne, hypercholesterolaemia, hyperlipidaemia, mouth ulcers and anaemia, all 10.5% each [37 ]. 

A retrospective study at 5 years post renal transplant in 131 patients (63 on sirolimus, 68 on cidosporin) living with a functional graft at 1 year showed the adverse events leading to discontinuation of sirolimus were mouth ulcer, proteinuria, pneumonia, peripheral oedema, hypercholesterolaemia, hyperlipidaemia and hypertriglyceridaemia [39 ]. 

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