Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Sirolimus

Immunosuppressant (mTOR inhibitor)

Brand names: Rapamune

Oral health effects

  • Aphthous-like oral ulceration (stomatitis)

    mTOR inhibitors characteristically cause painful, well-defined aphthous-like ulcers.

    Clinical management: Topical analgesia/corticosteroids; coordinate with the prescriber; can be dose-limiting.

  • Increased infection / candidiasis risk & delayed healing

    Systemic immunosuppression raises the risk of oral candidiasis, viral reactivation (HSV), and delayed wound healing.

    Clinical management: Monitor for fungal/viral infection; emphasize hygiene; consider antimicrobial prophylaxis per medical advice; plan atraumatic care and coordinate timing of invasive procedures.

Sources

  1. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  2. Adverse drug events in the oral cavity. Yuan A, Woo SB. Oral surgery, oral medicine, oral pathology and oral radiology, 2015.