Adults

Dosage varies significantly based on indication. For oncology, typically 10 mg intravenously or subcutaneously, administered by a healthcare professional following a specific protocol. For transplant, lower doses are generally used, often orally, but specific IV regimens may exist for initial loading or specific situations. Consult specific guidelines for precise dosing.

Elderly

No specific dose adjustment is generally required in elderly patients, but close monitoring for adverse effects is advised.

Renal_impairment

No dose adjustment is necessary for patients with mild to moderate renal impairment. Caution is advised for severe renal impairment, and close monitoring is recommended.

Onset

Rapid onset, typically within hours for immunosuppression; anti-tumor effects develop over time with sustained therapy.

Excretion

Primarily excreted in the feces as metabolites; minor excretion via urine.

Half life

Approximately 30-40 hours (average), with variability depending on patient factors and concomitant medications.

Absorption

Rapidly absorbed after intravenous administration, achieving peak concentrations quickly. Oral bioavailability is low and variable.

Metabolism

Extensively metabolized in the liver, primarily by CYP3A4. Active metabolites are not significant.

Live vaccines

Avoid co-administration due to immunosuppressive effects and increased risk of infection from live vaccines.

Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir)

Significantly increase everolimus blood levels, requiring dose reduction.

Strong CYP3A4 inducers (e.g., rifampicin, phenytoin, carbamazepine, St. John's Wort)

Significantly decrease everolimus blood levels, requiring dose increase.