Public record

Sirolimus: the public record

11 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for sirolimus

The FDA label read for sirolimus (Sirolimus, application NDA021083) was last revised on 2026-10-16. It carries a boxed warning headed "WARNING: IMMUNOSUPPRESSION, USE IS NOT RECOMMENDED IN LIVER OR LUNG TRANSPLANT PATIENTS". Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for sirolimus: the figures
MeasureValueNote
Label revision date2026-10-16
Label readSirolimusNDA021083, brand-name application
Boxed warningYesheading as printed: "WARNING: IMMUNOSUPPRESSION, USE IS NOT RECOMMENDED IN LIVER OR LUNG TRANSPLANT PATIENTS"
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient sirolimus from an original manufacturer

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

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Approvals

FDA approval history for sirolimus

The earliest FDA approval on file for a sirolimus product is 1999-09-15. Drugs@FDA lists 16 applications for it and 151 approved supplements, the most recent on 2026-09-02.

FDA approval history for sirolimus: the figures
MeasureValueNote
Earliest FDA approval on file1999-09-15
Applications with an approval on file16
New drug applications (NDA)5
Generic applications (ANDA)11
Approved supplements151label, manufacturing and efficacy changes
Most recent supplement approval2026-09-02
Sponsoring companies15

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient sirolimus product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

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Patents and generics

Patents and generic approvals for sirolimus

The FDA Orange Book lists 11 approved generic applications for sirolimus, the first approved on 2014-01-08. 8 listed patents on specific brand products have not yet expired, the last on 2045-04-11; generics of other versions are already approved.

Patents and generic approvals for sirolimus: the figures
MeasureValueNote
Brand-name applications (NDA)4
Approved generic applications (ANDA)11first approved 2014-01-08
Companies with a generic not marked discontinued10
Listed patents not yet expired8
Latest listed patent expiry2045-04-11on any product; may cover only one brand formulation
Latest listed exclusivity expiry2029-03-22exclusivity code ODE-391
Earliest approval date on file1999-09-15
Products not marked discontinued23 of 25

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient sirolimus products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

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Medicare Part D

Medicare Part D claims for sirolimus by age group

Of 40,710 Medicare Part D claims for sirolimus in 2024, 25,946 (63.7%) were for enrollees aged 65 and over and 14,764 were for enrollees under 65.

Medicare Part D claims for sirolimus by age group: the figures
MeasureValueNote
All Part D claims, 202440,710
Claims for enrollees aged 65 and over25,946
Claims for enrollees under 6514,764mostly people who qualify through disability
Share of claims for enrollees aged 65 and over63.7%share of claims, not of patients

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed the national rows for every brand and generic row with this generic name. Claims under 65 are total claims minus claims for enrollees 65 and over.

Scope: National Part D claims for single-ingredient sirolimus products, 2024, split at age 65

Medicare mostly covers people 65 and over, so this split describes Medicare enrollees and not use in the general population.

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Medicare Part D

Medicare Part D claims for sirolimus by state

California had the most Medicare Part D claims for sirolimus in 2024 (4,944), followed by Florida (3,717) and Texas (3,710). Prescribers in 51 states and territories wrote 40,581 claims in all.

Medicare Part D claims for sirolimus by state: the figures
MeasureValueNote
All states and territories, 202440,581 claims
States and territories with reported claims51
California4,944 claims$2.2M gross drug cost
Florida3,717 claims$1.5M gross drug cost
Texas3,710 claims$1.6M gross drug cost
New York2,488 claims$1.3M gross drug cost
Pennsylvania1,949 claims$1.2M gross drug cost

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed claims and drug cost by prescriber state over every brand and generic row with this generic name. Combination products excluded. Rows CMS suppressed for small counts are left out.

Scope: Part D claims for single-ingredient sirolimus products by the prescriber's state, 2024

State counts follow population size and where the prescriber practises. They are not per-person rates and do not show any state's coverage rules.

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Medicare Part D

Medicare Part D spending on sirolimus

Medicare Part D spending on sirolimus products was $19.1M in 2024 across 40,712 claims, compared with $24.2M in 2023 (-21.2%). Average spending per claim was $468, before rebates.

Medicare Part D spending on sirolimus: the figures
MeasureValueNote
Total spending, 2024$19.1M
Total spending, 2023$24.2M
Change in spending, 2023 to 2024-21.2%
Claims (prescription fills), 202440,712
Average spending per claim, 2024$468
Sirolimus: spending, 2024$17.5M40,187 claims
Hyftor: spending, 2024$1.4M375 claims
Rapamune: spending, 2024$223,979150 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient sirolimus product in Part D (Sirolimus, Hyftor, Rapamune), 2024.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

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Medicaid

Medicaid prescriptions for sirolimus by state

State Medicaid programmes paid for 44,962 sirolimus prescriptions in 2025, with $19.7M reimbursed before rebates. California reported the most (7,817), followed by New York (4,389) and Pennsylvania (3,432); 44 states and territories reported any.

Medicaid prescriptions for sirolimus by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 202544,962
Total reimbursed before rebates, 2025$19.7M
States and territories reporting44with at least one count CMS did not suppress
California7,817 prescriptions$3.5M reimbursed
New York4,389 prescriptions$1.5M reimbursed
Pennsylvania3,432 prescriptions$1.6M reimbursed
Illinois2,507 prescriptions$928,018 reimbursed
Texas2,476 prescriptions$1.6M reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient sirolimus products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

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Pharmacy cost

Pharmacy acquisition cost (NADAC) for sirolimus

Retail pharmacies paid an average of $0.7127 per unit for SIROLIMUS 1 MG TABLET as of 2026-11-11, compared with $1.48 twelve months earlier (-51.8%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for sirolimus: the figures
MeasureValueNote
SIROLIMUS 1 MG TABLET$0.7127 per unit12 months earlier $1.48 (-51.8%)
SIROLIMUS 1 MG/ML SOLUTION$4.21 per mL12 months earlier $4.89 (-14.0%)
SIROLIMUS 0.5 MG TABLET$0.8326 per unit12 months earlier $1.80 (-53.8%)
SIROLIMUS 2 MG TABLET$2.35 per unit12 months earlier $4.85 (-51.4%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of sirolimus in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

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Adverse event reports

Most reported events in FDA adverse event reports for sirolimus

Through 2026-10-28, FDA had received 16,899 adverse event reports for sirolimus, 13,616 of them marked serious by the reporter. The symptom terms named most often were transplant rejection (809), pneumonia (787) and diarrhoea (671).

Most reported events in FDA adverse event reports for sirolimus: the figures
MeasureValueNote
All reports received16,899
Reports the reporter marked serious13,616death, hospitalisation, disability or similar outcome
Transplant rejection809 reports
Pneumonia787 reports
Diarrhoea671 reports
Pyrexia617 reports
Acute kidney injury518 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug. Terms about product use or complaints rather than symptoms (for example off label use) were left out of the list.

Scope: Reports where FDA recorded sirolimus as a single-ingredient active substance (any brand), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

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Recalls

FDA drug recalls naming sirolimus

FDA enforcement reports list 6 drug recall entries naming sirolimus from 2014 to 2024-05-29. 3 of them are for compounded or other unlisted products and 3 for products FDA lists under a label. The most common stated reason was impurities or nitrosamines (3 of 6).

FDA drug recalls naming sirolimus: the figures
MeasureValueNote
Recall entries on record6
For products FDA lists under an approved or registered label3
For compounded or other unlisted products3matched by the name in the product description
Class I (most serious)0
Class II1
Class III5
Most recent recall reported2024-05-29
Most common stated reasonimpurities or nitrosamines3 of 6 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient sirolimus products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

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Clinical studies

Registered clinical studies of sirolimus

ClinicalTrials.gov lists 2,393 registered studies that name sirolimus as an intervention as of 2026-11-11. Of these, 195 are recruiting, 1,303 are completed and 259 are phase 3 studies.

Registered clinical studies of sirolimus: the figures
MeasureValue
Registered studies2,393
Recruiting now195
Not yet recruiting56
Completed1,303
Terminated, withdrawn or suspended379
Phase 3 (including phase 2/3)259
Phase 2 (including phase 1/2)945
Phase 1432

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches sirolimus, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

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Articles on Sirolimus