ACE Inhibitors/mTOR Inhibitors Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines cause blood vessels to dilate.

What might happen:

You may develop a potentially life-threatening reaction called angioedema.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you develop swollen skin (especially in the face or tongue), hoarseness, a tight or swollen throat, or trouble breathing.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

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  • 2.Afinitor (everolimus) US prescribing information. Novartaris Pharmaceuticals Corporation February, 2020.
  • 3.Rothermundt C, Gillessen S. Angioedema in a patient with renal cell cancer treated with everolimus in combination with an angiotensin-converting enzyme inhibitor. J Clin Oncol 2013 Feb 10;31(5):e57-8.
  • 4.Jung M, Ranpura VN, Dunbar CE, Tisdale JF, Fitzhugh CD, Hsieh MM. Angioedema in patients treated with sirolimus and ACE inhibitor post hematopoietic SCT. Bone Marrow Transplant 2014 Nov;49(11):1448-9.
  • 5.Charmillon A, Deibener J, Kaminsky P, Louis G. Angioedema induced by angiotensin converting enzyme inhibitors, potentiated by m-TOR inhibitors: successful treatment with icatibant. Intensive Care Med 2014 Jun; 40(6):893-4.
  • 6.Burdese M, Rossetti M, Guarena C, Consiglio V, Mezza E, Soragna G, Gai M, Segoloni GP, Piccoli GB. Sirolimus and ACE-inhibitors: a note of caution. Transplantation 2005 Jan 27;79(2):251-2.
  • 7.Stallone G, Infante B, Di Paolo S, Schena A, Grandaliano G, Gesualdo L, Schena FP. Sirolimus and angiotensin-converting enzyme inhibitors together induce tongue oedema in renal transplant recipients. Nephrol Dial Transplant 2004 Nov;19(11):2906-8.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.