Certican 0.25mg Tablet

Certican 0.25mg Tablet contains everolimus 0.25mg, an mTOR (mammalian target of rapamycin) inhibitor used together with other immunosuppressant medicines, such as a calcineurin inhibitor and a corticosteroid, to help prevent organ rejection in people who have received a kidney, heart, or liver transplant. This medicine must only be used under the close supervision of a specialist transplant team, as part of a carefully individualised immunosuppressive regimen.

Everolimus works by blocking a pathway inside immune cells that they need in order to multiply. By slowing the proliferation of the immune cells that would otherwise attack the transplanted organ, everolimus helps protect the transplant while working alongside your other immunosuppressant medicines.

Everolimus binds to an intracellular protein called FKBP-12, and the resulting complex inhibits mTOR, a key regulator of cell growth and proliferation. In transplant recipients, this blocks the proliferation of T-lymphocytes and other immune cells that would otherwise respond to the transplanted organ as foreign, working through a different pathway from – and therefore complementing – other immunosuppressants such as calcineurin inhibitors.

Take Certican 0.25mg Tablet consistently, either always with food or always without food (as advised by your transplant team), at the same times each day approximately 12 hours apart, and always alongside your other prescribed immunosuppressants. Swallow the tablet(s) whole with water. Attend every scheduled blood test to monitor your everolimus levels, kidney and liver function, and blood counts, as your transplant team uses these results to fine-tune your dose.

The dose of Certican 0.25mg Tablet is individualised precisely by your transplant specialist based on regular blood tests measuring your everolimus levels, together with your kidney and liver function, your other immunosuppressant doses, and your clinical response. It is usually taken twice daily, exactly as prescribed. Never adjust your own dose or stop taking this medicine without your transplant team’s explicit instruction, as this can put your transplanted organ at risk of rejection.

Use this product before the expiry date stated on the packaging. Do not use the medicine if the expiry date has passed.

Store below 25°C in the original blister pack to protect the tablets from light and moisture. Do not remove a tablet from the blister until immediately before you take it, and keep out of reach of children.

• Known hypersensitivity to everolimus, sirolimus, or any ingredient in this product
• Use without close specialist transplant-team supervision and regular blood monitoring
• Severe, uncontrolled active infection
• Live vaccines should not be given during treatment – check with your transplant team before any vaccination

• Potent CYP3A4/P-glycoprotein inhibitors (e.g. ketoconazole, ritonavir, clarithromycin) can markedly increase everolimus blood levels
• Potent enzyme inducers (e.g. rifampicin, carbamazepine, St John’s Wort) can reduce everolimus blood levels
• Grapefruit and grapefruit juice must be avoided completely, as they can significantly raise everolimus levels
• Other immunosuppressants such as ciclosporin have important interactions with everolimus that your transplant team manages as part of your overall regimen

• Never skip a scheduled blood test – your dose depends on the results
• Avoid grapefruit and grapefruit juice completely
• Check with your transplant team before receiving any vaccination, especially live vaccines
• Report any fever, infection symptoms, unusual bruising, or bleeding to your transplant team promptly
• Never adjust your dose or stop this medicine on your own