Sirolimus Coupons & Prices

A sirolimus coupon from Rx.com can lower what you pay at the pharmacy counter for generic sirolimus tablets and oral solution, the mTOR inhibitor immunosuppressant formerly sold under the brand name Rapamune. Pfizer stopped selling brand Rapamune in the United States effective December 31, 2023, and many manufacturers now produce generic sirolimus, so the generic is what US pharmacies dispense. Sirolimus is FDA-approved to help prevent organ rejection in kidney transplant patients 13 years and older and to treat lymphangioleiomyomatosis (LAM), a rare progressive lung disease. Cash prices for the same prescription can differ a great deal from one pharmacy to the next, even across the street, so it is worth comparing before you fill. Enter your ZIP code above to see today's price at pharmacies near you. Rx.com compares prices at more than 60,000 pharmacies nationwide, and the coupon is free to use with or without insurance.

What is sirolimus and how does it work?

Sirolimus, also known as rapamycin, is a macrolide immunosuppressant that works as an mTOR inhibitor (it is also classed as a kinase inhibitor). By blocking the mTOR pathway, it dampens the activity of immune cells that would otherwise attack a transplanted organ, and it slows the growth of certain abnormal cells. It is taken by mouth as a tablet or an oral solution.

Sirolimus tablets and oral solution are FDA-approved for two uses: prophylaxis of organ rejection in kidney (renal) transplant patients aged 13 years and older, generally in combination with cyclosporine and corticosteroids; and treatment of lymphangioleiomyomatosis (LAM), approved in May 2015. Sirolimus therapy requires therapeutic drug monitoring, meaning your transplant team checks whole-blood trough levels with blood tests to keep you in the right range. One important distinction: Fyarro (sirolimus protein-bound particles for injection) is a separate FDA-approved intravenous product for malignant PEComa. It is not interchangeable with sirolimus tablets or oral solution, and this page is about the oral forms.

Sirolimus cost and coupon savings without insurance

Sirolimus is available as an FDA-approved generic from multiple manufacturers, and since Pfizer discontinued brand Rapamune in the US at the end of 2023, the generic is what you will be filling. That said, do not assume the price is the same everywhere. Cash prices for generic sirolimus vary widely by pharmacy, by strength, and by quantity, and the difference between two pharmacies in the same town can be substantial. That is exactly why comparing matters. Enter your ZIP above to see today's price near you and print, text, or show the free Rx.com coupon at the counter.

If you are paying cash or have a high deductible, a few honest things to know. Ask your prescriber whether a 90-day supply is appropriate, since larger fills are often priced differently per unit. Ask the pharmacist for the cash price with the coupon and compare it with what your insurance would charge, because the coupon price is sometimes lower than a copay. You cannot combine a discount coupon with insurance on the same fill, so use whichever is cheaper.

Because brand Rapamune is no longer marketed in the US, there is no brand manufacturer savings card or brand patient assistance program for it that we can point you to. Do not spend time chasing one. The paths that are actually worth your time: start with your transplant center's financial counselor, whose job is to find you the cheapest route and who knows which programs are currently open. If you had a kidney transplant at a Medicare-approved facility, ask specifically about the Medicare Part B immunosuppressive drug benefit (Part B-ID), which can cover transplant immunosuppressants for people who meet its eligibility rules and have no other qualifying coverage. Individual generic manufacturers sometimes run their own assistance programs, so it is worth asking your pharmacist who makes your fill. Nonprofit grant funds for transplant patients also exist, including through the American Kidney Fund, the American Transplant Foundation, and the HealthWell Foundation, but these funds open and close as their funding allows, so check current status directly rather than assuming a fund is accepting applications.

Sirolimus vs. other transplant medicines

Sirolimus is one of several immunosuppressants used after transplant, and they are not interchangeable. Your transplant team chooses a combination based on your organ, your kidney function, your other medicines, and how you tolerate them. Related medicines you may see on your regimen or hear compared with sirolimus include:

• Rapamune — the former brand name for oral sirolimus, marketed in the US by Pfizer (originally Wyeth) until it was discontinued here effective December 31, 2023. Generic sirolimus contains the same active ingredient.
• everolimus — the other oral mTOR inhibitor.
• tacrolimus and cyclosporine — calcineurin inhibitors; sirolimus is FDA-approved for kidney transplant generally in combination with cyclosporine and corticosteroids.
• mycophenolate mofetil and azathioprine — antimetabolite immunosuppressants.
• prednisone — the corticosteroid commonly used as part of a transplant regimen.

Never switch, stop, or adjust an immunosuppressant on your own, even to save money. Small changes in blood levels matter for these drugs. If cost is the reason you are considering a change, tell your transplant team first, and compare pharmacy prices here in the meantime.

Sirolimus safety, side effects, and interactions

Sirolimus carries a boxed warning: immunosuppression increases your susceptibility to infection and the possible development of lymphoma and other malignancies, including skin cancer. The boxed warning also states that sirolimus is not recommended in liver transplant patients. Specifically, the label reports that in a study in de novo liver transplant patients, sirolimus used in combination with tacrolimus was associated with excess mortality and graft loss, with many of those patients having evidence of infection at or near the time of death; the label separately notes an increase in hepatic artery thrombosis (usually within 30 days of transplant, and most cases leading to graft loss or death) when sirolimus was used with either cyclosporine or tacrolimus in de novo liver transplant patients. The safety and efficacy of sirolimus in liver transplant have not been established, so such use is not recommended. The boxed warning likewise states sirolimus is not recommended in lung transplant patients (cases of bronchial anastomotic dehiscence, often fatal). It should be used only under the supervision of physicians experienced in immunosuppressive therapy and transplant management.

Other important risks on the label include high cholesterol and triglycerides, impaired or delayed wound healing and lymphocele, interstitial lung disease and pneumonitis, angioedema (more likely with ACE inhibitors), proteinuria (notably when converting from a calcineurin inhibitor), decreased kidney function when used with cyclosporine, and fluid accumulation. Sirolimus can cause fetal harm, so pregnancy should be avoided during therapy and for 12 weeks after the last dose. Sirolimus is processed through CYP3A4 and P-glycoprotein and has extensive drug interactions: avoid strong inhibitors such as ketoconazole and strong inducers such as rifampin, and avoid grapefruit juice. Live vaccines should be avoided. Because of infection and skin cancer risk, use sun protection and report fevers or new symptoms promptly. Tell your prescriber and pharmacist about every medicine and supplement you take. This page is general information, not medical advice; talk with your provider or transplant pharmacist about your own situation.

A note on "rapamycin for longevity"

Sirolimus and rapamycin are the same drug, and you may have seen rapamycin promoted online or through compounding pharmacies for anti-aging or longevity. That is not an FDA-approved use, and it is not supported by adequate human outcome data. Sirolimus is a boxed-warning immunosuppressant that raises infection and cancer risk and needs blood-level monitoring, so it is not something to take casually or on your own. Rx.com does not promote off-label use. If you are curious about it, that is a conversation to have with a physician who knows your full history.