How is everolimus dose adjusted for hepatic impairment?

Everolimus 10 mg/day for oncology indications. Hepatic adjustment (Afinitor label): Child-Pugh A (mild): reduce to 7.5 mg/day. Child-Pugh B (moderate): reduce to 5 mg/day. Child-Pugh C (severe): reduce to 2.5 mg/day. Transplant (Zortress): similar proportional reductions. Monitor trough levels (target 3–8 ng/mL for oncology).

What drug interactions most significantly affect everolimus levels?

CYP3A4/P-gp strong inhibitors (ketoconazole, itraconazole, voriconazole, ritonavir, clarithromycin): avoid or reduce dose dramatically (target lower range). Strong inducers (rifampin, phenytoin, carbamazepine): increase everolimus dose to maintain target. Grapefruit juice increases everolimus AUC 30–75%.

Everolimus Dose Adjustment for Hepatic Impairment

Adjust everolimus dose for hepatic impairment in oncology and transplant settings: mild (Child-Pugh A), moderate (B), and severe (C) with specific dose reduction recommendations.

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Frequently Asked Questions

How is everolimus dose adjusted for hepatic impairment?

What drug interactions most significantly affect everolimus levels?