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Torisel 25mg/ml Vial
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Indications & Clinical Uses
- Torisel (temsirolimus) 25 mg/mL is a kinase inhibitor targeting mTOR (mammalian target of rapamycin), supplied as a kit containing the concentrate vial plus a diluent vial, for further dilution into intravenous fluid before infusion.
- It is approved for the treatment of advanced renal cell carcinoma (a type of kidney cancer) in adults.
- Torisel is manufactured by Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer Inc. (matching the sheet's 'Pfizer' manufacturer entry).
- It is given once weekly as an intravenous infusion over 30 to 60 minutes, with an antihistamine given beforehand to reduce the risk of an infusion reaction.
- Torisel is administered only by a healthcare provider in a hospital or oncology infusion unit; it is never a take-home or self-injected medicine.
Side Effects
- Torisel has no boxed warning, but hypersensitivity and infusion-related reactions, including rare anaphylaxis, can occur, sometimes during the very first infusion, which is why a premedication such as diphenhydramine is given beforehand.
- Very common effects include rash, weakness, mouth sores, nausea, swelling, loss of appetite, and raised blood sugar and cholesterol levels.
- Serious risks the patient must recognise include interstitial lung disease (new cough, breathlessness), bowel perforation (severe abdominal pain, fever), unusual bleeding, and signs of infection, since Torisel suppresses the immune system - report fever, chills or a new persistent cough promptly.
- Kidney failure, sometimes fatal, has occurred in patients with advanced kidney cancer receiving Torisel.
- Blood sugar and cholesterol are checked regularly during treatment.
Precautions & Warnings
- Torisel is contraindicated if bilirubin is more than 1.5 times the upper limit of normal, since liver impairment significantly raises drug exposure; liver function is checked before and during treatment.
- Blood glucose and cholesterol/triglycerides are monitored throughout, as Torisel commonly raises both.
- Wound healing can be impaired, so Torisel is usually stopped before and after major surgery until healing is complete.
- It can cause fetal harm, so effective contraception is required during treatment and for a period afterwards, and it is avoided in pregnancy and while breastfeeding.
- Vaccination with live vaccines should be avoided during treatment because of immune suppression.
- Interstitial lung disease and bowel perforation, both potentially serious, are monitored for throughout treatment, and Torisel is given only under specialist oncology supervision.
Avoid Interactions
- Torisel is broken down by the CYP3A4 liver enzyme, so strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin and ritonavir raise temsirolimus levels and increase toxicity - the dose is reduced (to 12.5 mg/week) if such a combination cannot be avoided.
- Strong CYP3A4 inducers such as rifampin, phenytoin, carbamazepine and St John's Wort lower temsirolimus levels and can reduce its effect - the dose may need to be increased (to 50 mg/week) if unavoidable.
- Avoid grapefruit and grapefruit juice, which also affect CYP3A4.
- Combining Torisel with sunitinib is avoided because of dose-limiting skin and gout-like toxicity seen together.
- Avoid live vaccines during treatment.
- Tell your oncology team about every prescription, over-the-counter medicine, herbal remedy and supplement you take.
References
Frequently Asked Questions
Torisel (temsirolimus) treats advanced renal cell carcinoma, a type of kidney cancer, in adults. It's an mTOR-inhibitor given as a weekly intravenous infusion, usually when the cancer has spread or cannot be removed by surgery.
Torisel is given once a week as an intravenous infusion over 30 to 60 minutes in a hospital or cancer clinic. An antihistamine is given beforehand to reduce the chance of an infusion reaction. You do not give Torisel to yourself.
Torisel commonly causes rash, weakness, mouth sores, nausea and raised blood sugar or cholesterol. Serious risks include lung inflammation, bowel perforation and infusion reactions. Report new breathlessness, severe stomach pain, fever or unusual bleeding to your care team straight away.
Avoid grapefruit and St John's Wort, both of which change Torisel levels in your blood. Avoid live vaccines during treatment. Tell your oncology team about antifungal drugs like ketoconazole and seizure medicines like phenytoin, which also interact with Torisel.
During Torisel treatment, your blood sugar, cholesterol, triglycerides and liver function are checked regularly, since Torisel commonly raises blood sugar and cholesterol and can affect the liver. Torisel is avoided if your bilirubin is already too high.
Torisel can slow wound healing, so it is usually stopped before planned surgery and not restarted until the wound has healed. Tell your surgical and oncology teams about any upcoming procedure while you are being treated with Torisel.
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