When You Can't Get Everolimus, What Are Your Options?

If you've been prescribed Everolimus (brand names Afinitor, Afinitor Disperz, or Zortress) and you're having trouble filling your prescription — whether because of a shortage, cost, or insurance issues — you may be wondering if there's something else that could work.

The short answer: there may be alternatives, but only your doctor can decide if one is right for you. Everolimus is used for several serious conditions, and the best alternative depends on what you're being treated for.

In this article, we'll explain what Everolimus does, how it works, and walk you through the most common alternatives that doctors may consider.

What Is Everolimus?

Everolimus is an mTOR inhibitor — a type of targeted therapy that blocks a protein called mTOR (mechanistic target of rapamycin). This protein helps cells grow and divide. By inhibiting mTOR, Everolimus slows down the growth of cancer cells and suppresses the immune system.

Everolimus is FDA-approved for:

• Advanced renal cell carcinoma (kidney cancer) after other treatments have stopped working
• Hormone receptor-positive, HER2-negative breast cancer (used with Exemestane)
• Neuroendocrine tumors of the GI tract or lungs
• Subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC)
• Renal angiomyolipoma with TSC
• Kidney transplant rejection prevention (as Zortress)

For a complete overview, see our guide on what Everolimus is, its uses, and dosage.

How Does Everolimus Work?

Everolimus binds to a protein inside your cells called FKBP-12. Together, they form a complex that blocks mTOR complex 1 (mTORC1). When mTORC1 is blocked:

• Cancer cells grow and divide more slowly
• New blood vessel formation (angiogenesis) is reduced, cutting off the tumor's blood supply
• The immune system is suppressed (helpful in transplant patients, but a side effect in cancer patients)

Learn more in our detailed article on how Everolimus works.

Alternatives to Everolimus

The right alternative depends entirely on your diagnosis. Here are the medications doctors most commonly consider:

1. Sirolimus (Rapamune)

Drug class: mTOR inhibitor

Used for: Kidney transplant rejection prevention, lymphangioleiomyomatosis (LAM)

Sirolimus is the closest relative to Everolimus — both are mTOR inhibitors derived from the same parent compound (rapamycin). If you're taking Zortress for transplant rejection, your doctor may consider switching to Sirolimus, which has been available longer and may be easier to find.

Sirolimus is available as tablets and an oral solution, and generic versions are widely available, which can make it more affordable. However, dosing and monitoring requirements differ from Everolimus, so your doctor will need to adjust your treatment plan carefully.

2. Temsirolimus (Torisel)

Drug class: mTOR inhibitor

Used for: Advanced renal cell carcinoma

Temsirolimus is another mTOR inhibitor, but it's given as a weekly IV infusion rather than a daily pill. It's approved for advanced kidney cancer and may be an option if you can't access oral Everolimus. The main trade-off is convenience — you'll need to visit a clinic or infusion center weekly.

3. Palbociclib (Ibrance)

Drug class: CDK4/6 inhibitor

Used for: HR-positive, HER2-negative advanced breast cancer

If you're taking Everolimus for breast cancer, Palbociclib is one of the most commonly used alternative targeted therapies. It works differently — blocking CDK4/6 proteins instead of mTOR — but it's used for the same type of breast cancer (HR+/HER2-). Other CDK4/6 inhibitors like Ribociclib (Kisqali) and Abemaciclib (Verzenio) are also options in this category.

Your oncologist can help determine which targeted therapy is best based on your specific cancer characteristics and treatment history.

4. Sunitinib (Sutent)

Drug class: Multi-targeted tyrosine kinase inhibitor

Used for: Advanced renal cell carcinoma, gastrointestinal stromal tumors (GIST)

For kidney cancer patients, Sunitinib is a different class of targeted therapy that may be considered, particularly if you haven't used it previously. It works by blocking multiple tyrosine kinases involved in tumor growth and blood vessel formation. Other tyrosine kinase inhibitors like Axitinib (Inlyta), Cabozantinib (Cabometyx), and Lenvatinib (Lenvima) may also be options.

Important: Don't Switch on Your Own

Never stop taking Everolimus or switch to another medication without talking to your doctor. These are serious medications used for serious conditions, and changing your treatment without medical guidance can be dangerous. If you're having trouble filling your prescription:

1. Call your doctor's office immediately and explain the situation
2. Ask if a dose adjustment or temporary alternative is possible
3. Use Medfinder to check if Everolimus is available at another pharmacy nearby
4. Contact your specialty pharmacy to see when they expect more stock

What About Generic Everolimus?

Before switching to a completely different medication, ask about generic Everolimus. It's now available for several strengths and may be easier to find and more affordable than brand-name Afinitor. Your pharmacist can check if a generic version is available for your specific prescription.

For tips on reducing your costs, see our guide on how to save money on Everolimus.

Final Thoughts

Having trouble accessing your medication is stressful, especially when it's something as important as Everolimus. While there are alternatives available for most conditions Everolimus treats, the decision to switch should always be made with your doctor.

In the meantime, use every tool at your disposal — Medfinder for stock checks, patient assistance programs for cost help, and your care team for guidance. You have options, and you don't have to figure this out alone.

Read more: How to find Everolimus in stock near you