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mTOR inhibitor

Everolimus

Brand names: Afinitor, Votubia, Certican

Adult dose

Dose: Oncology: 10mg OD. Transplant: 0.75–1.5mg BD adjusted to trough levels
Route: PO
Frequency: OD or BD

Clinical pearls

  • Renal/breast cancer, NET, TSC, transplant
  • Monitor trough levels in transplant

Contraindications

  • Hypersensitivity
  • Active severe infection

Side effects

  • Stomatitis
  • Non-infectious pneumonitis
  • Hyperglycaemia
  • Hyperlipidaemia
  • Increased infection risk
  • Wound-healing impairment
  • Proteinuria

Interactions

  • Strong CYP3A4/PgP modulators — major dose changes
  • ACE inhibitors (angioedema risk in transplant)
  • Live vaccines

Monitoring

  • FBC
  • Glucose
  • Lipids
  • LFTs
  • U&E
  • Trough levels (transplant)

Reference: BNF; NICE TA432/TA421; SmPC; https://bnf.nice.org.uk/drugs/everolimus/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.