Everolimus: What it Treats and What to Watch For

Everolimus is a drug you’ll hear about in oncology and transplant care. It works on the mTOR pathway to slow cell growth and tame the immune system. That makes it useful for certain cancers and for preventing organ rejection after transplant. If you’ve been prescribed everolimus, here’s what matters most in plain language.

What you need to know before taking everolimus

Everolimus comes as an oral tablet. Doses vary by condition: oncology and transplant teams use different schedules, so always follow your prescriber. Tell your doctor about other drugs you take — everolimus is processed by the CYP3A4 system. Strong inhibitors (for example, ketoconazole or clarithromycin) can raise levels. Strong inducers (like rifampin or phenytoin) can lower levels and reduce effectiveness. Avoid grapefruit and grapefruit juice while on everolimus.

Don’t start everolimus if you have an active serious infection. Vaccines with live organisms should be avoided during treatment and sometimes for months after — check with your provider. If you’re pregnant or planning to become pregnant, talk to your doctor: everolimus can harm an unborn baby. Also avoid breastfeeding while on the drug.

Managing side effects and monitoring

Side effects can be uncomfortable but many are manageable. Common ones include mouth sores (stomatitis), infections, tiredness, rash, high blood sugar, and raised cholesterol. A less common but serious problem is non-infectious pneumonitis — if you develop a new cough or shortness of breath, call your doctor right away.

Your care team will likely order blood tests before and during treatment: blood counts, kidney and liver checks, fasting glucose, and lipids. They may also check drug levels or adjust other medicines you take. If you need surgery or dental work, tell the surgeon or dentist you’re on everolimus — the drug can affect wound healing.

Simple steps can help: rinse your mouth often and use alcohol-free mouthwash to reduce stomatitis. Keep blood sugar and cholesterol under control with diet, exercise, and medicines if needed. Report any fever or signs of infection immediately. If you miss a dose, follow your prescriber’s instructions — generally take it as soon as you remember unless it’s almost time for the next dose.

Storage is easy: keep tablets at room temperature away from moisture. Never share your medication. If you have questions about interactions, vaccines, or planning a pregnancy, bring them up with your specialist — they’ll tailor advice to your condition. Everolimus can be very effective when used carefully, and knowing what to watch for makes treatment safer and smoother.