Just make sure that you physician knows that you’re on Rapamycin, and where in the “cycle” you are on it. Meaning day 1 vs day 7.
I980 I was on Simvastatin. I developed community pneumonia and went to a walk-in clinic. The doc there put me on Erythromycin. About 4pm the next day I felt like I could hardly walk and then had a flash of insight and used a urine dipstick and the section for blood in the urine turned black, poof.
There was no “blood,” in the urine but I had developed rhabdomyolysis and there was plenty of myoglobin from damaged muscle cells. Had I kept taking that erythromycin another day I would have likely destroyed my kidneys. That doc made no attempt to look at Cytochrome P450 interactions and strangely neither did the CVS computer system that should have beeped a warning.
Due to its inhibition of CYP3A4 and ABCB1, erythromycin has been shown to result in a sixfold increase in the AUC of simvastatin, which is metabolized by CYP3A4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346035/
What happened is the blood level of simvastatin rose to a toxic level.
W/ Rapamycin a CYP3A4 inducer would be ok (I think, correct me if I’m wrong) as that would simply cause the blood level of Rapamycin to drop, but an inhibitor such as erythromycin could cause the blood level of Rapamycin to rapidly increase, possibly by a 6x factor.
So which ones should be ok w/ Rapa?
In contrast to erythromycin and clarithromycin, azithromycin does not seem to interact with SLCO1B1 or SLCO1B3 [6]. Azithromycin has been shown to be a weak substrate for CYP3A4, to be minimally metabolized by the enzyme, and to neither induce nor inhibit CYP3A4 activity [[16]
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346035/#R16)].
Therefore it appears to me that Azithro would be ok, this stuff gives me a headache, but it’s important to know, especially w/ the long half-life of Rapa.