Indications

Transplantation

• Anti-Rejection Agent for Solid Organ Transplant
  • Liver Transplant (see Liver Transplant, [[Liver Transplant]])

TSC-Related Disorders

• Lymphangioleiomyomatosis (LAM) (see Lymphangioleiomyomatosis, [[Lymphangioleiomyomatosis]])
  • Pulmonary LAM: although everolimus is not FDA-approved for the treatment of pulmonary LAM, it has been used off-label in patients who do not tolerate sirolimus
    • Demonstrated to improve FEV1 and 6-minute walk distance [MEDLINE]
  • Lymphangioleiomyomas: everolimus has been shown to have benefit, with resolution of tumors [MEDLINE]
• Tuberous Sclerosis (see Tuberous Sclerosis, [[Tuberous Sclerosis]])

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Pharmacology

• Mechanistic Target of Rapamycin (mTOR) Inhibitor (see Mechanistic Target of Rapamycin Inhibitors, [[Mechanistic Target of Rapamycin Inhibitors]]): unlike tacrolimus, everolimus is not a calcineurin inhibitor
  • Antiproliferative Properties
  • Immunosuppressive Properties

Metabolism

• xxx

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Administration

• xxx

Dose Adjustment

• Hepatic
• Renal

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Adverse Effects

Cardiovascular Adverse Effects

Congestive Heart Failure (CHF) (see xxxx, [[xxxx]])

• xxx

Infectious Adverse Effects

Increased Risk of Pneumocystis Jirovecii (see xxxx, [[xxxx]]) [MEDLINE]

• xxx

Pulmonary Adverse Effects

Subacute Interstitial Pneumonitis (see Interstitial Lung Disease, [[Interstitial Lung Disease]])

• xxxx

Cryptogenic Organizing Pneumonia (COP) (see Cryptogenic Organizing Pneumonia, [[Cryptogenic Organizing Pneumonia]])

• xxxx

Rheumatologic Adverse Effects

• Peripheral Edema (see xxxx, [[xxxx]])

Other Adverse Effects

• xxxx
• xxxx
• xxxx
• xxxx

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References

• Everolimus for subependymal giant-cell astrocytomas in tuberous sclerosis. N Engl J Med. 2010;363:1801-11 [MEDLINE]
• Everolimus treatment of abdominal lymphangioleiomyoma in five women with sporadic lymphangioleiomyomatosis. Med J Aust. 2013 Jul;199(2):121-3 [MEDLINE]
• Everolimus for the treatment of lymphangioleiomyomatosis: a phase II study. Eur Respir J. 2015 Sep;46(3):783-94. Epub 2015 Jun 25 [MEDLINE]
• mTOR treatment in lymphangioleiomyomatosis. Expert Rev Respir Med. 2016 Feb 4 [MEDLINE]