Sirolimus and cyclosporine are being used to prevent renal transplant rejection in an adult patient. What principle should guide the nurse's administration of these two drugs?
A) Sirolimus should be given orally; cyclosporine should be administered IV.
B) The two drugs should be administered together to potentiate their effects.
C) The two drugs should be given at least 4 hours apart.
D) The drugs should be administered in a single intramuscular injection.
C
Feedback:
Sirolimus may have synergistic effects with cyclosporine because it has a different mechanism of action, and prescribers may order both drugs in combination. However, because the two drugs are metabolized by the same liver CYP3A4 enzymes, cyclosporine can increase blood levels of sirolimus, potentially to toxic levels. Consequently, it is essential that the drugs not be given at the same time; patients should take sirolimus 4 hours after a dose of cyclosporine.
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