What medications interact with lanreotide (Somatuline)?

From the Guidelines

Lanreotide can interact with several medications, including cyclosporine, insulin, oral antidiabetic medications, beta-blockers, and levothyroxine, requiring careful monitoring and potential dose adjustments. The most significant interactions occur with cyclosporine, which may have reduced blood levels when taken with lanreotide, necessitating dose adjustments and therapeutic drug monitoring 1. Lanreotide can also affect blood glucose levels, so insulin and oral antidiabetic medications may need dose adjustments to prevent hypoglycemia or hyperglycemia. Bradycardia-inducing drugs like beta-blockers (metoprolol, propranolol) should be used cautiously as lanreotide can slow heart rate. Additionally, lanreotide may decrease the absorption of orally administered medications due to its effects on gastrointestinal motility, particularly affecting drugs that require specific absorption times like levothyroxine. Some key points to consider when prescribing lanreotide include:

• Monitoring blood glucose levels in patients taking insulin or oral antidiabetic medications
• Adjusting doses of cyclosporine and other medications that may interact with lanreotide
• Using beta-blockers with caution due to the potential for additive effects on heart rate
• Considering alternative medications or dose adjustments for patients taking levothyroxine or other medications that may be affected by lanreotide's effects on gastrointestinal motility. It is essential to inform all healthcare providers about lanreotide use to prevent potential drug interactions, as noted in studies on somatostatin analogues 1.

From the FDA Drug Label

7 DRUG INTERACTIONS

7.1 Insulin and Oral Hypoglycemic Drugs Lanreotide, like somatostatin and other somatostatin analogs, inhibits the secretion of insulin and glucagon. Therefore, blood glucose levels should be monitored when Lanreotide Injection treatment is initiated or when the dose is altered, and antidiabetic treatment should be adjusted accordingly 7. 2 Cyclosporine Concomitant administration of cyclosporine with Lanreotide Injection may decrease the absorption of cyclosporine, and therefore, may necessitate adjustment of cyclosporine dose to maintain therapeutic drug concentrations. 7. 3 Bromocriptine Limited published data indicate that concomitant administration of a somatostatin analog and bromocriptine may increase the absorption of bromocriptine 7.4 Bradycardia-Inducing Drugs Concomitant administration of bradycardia-inducing drugs (e.g., beta-blockers) may have an additive effect on the reduction of heart rate associated with lanreotide. Dosage adjustments of concomitant drugs may be necessary. 7. 5 Drug Metabolism Interactions The limited published data available indicate that somatostatin analogs may decrease the metabolic clearance of compounds known to be metabolized by cytochrome P450 enzymes, which may be due to the suppression of growth hormone Since it cannot be excluded that Lanreotide Injection may have this effect, avoid other drugs mainly metabolized by CYP3A4 and which have a low therapeutic index (e.g., quinidine, terfenadine). Drugs metabolized by the liver may be metabolized more slowly during Lanreotide Injection treatment and dose reductions of the concomitantly administered medications should be considered

The medications that interact with lanreotide are:

• Insulin and oral hypoglycemic drugs: lanreotide may inhibit the secretion of insulin and glucagon, requiring monitoring of blood glucose levels and adjustment of antidiabetic treatment 2
• Cyclosporine: concomitant administration may decrease the absorption of cyclosporine, requiring adjustment of cyclosporine dose 2
• Bromocriptine: concomitant administration may increase the absorption of bromocriptine 2
• Bradycardia-inducing drugs (e.g., beta-blockers): concomitant administration may have an additive effect on the reduction of heart rate, requiring dosage adjustments of concomitant drugs 2
• Drugs mainly metabolized by CYP3A4 with a low therapeutic index (e.g., quinidine, terfenadine): avoid concomitant use due to potential decrease in metabolic clearance 2

From the Research

Medications Interacting with Lanreotide

There are no research papers provided to assist in answering this question about medications that interact with lanreotide. The studies available discuss:

• The combination of calcium-channel blockers and beta blockers in the treatment of chronic stable angina pectoris 3
• The comparative hypotensive effects of verapamil and propranolol in patients with mild to moderate hypertension 4
• Switching between β-blockers for cardiovascular disease therapy 5
• The Ca2+ channel-blocking activity of propranolol and betaxolol in isolated bovine retinal microartery 6 None of these studies mention lanreotide or its interactions with other medications.

Key Points

• The provided studies do not address lanreotide or its potential interactions.
• Lanreotide is a somatostatin analogue used in the treatment of certain medical conditions, but its interactions are not discussed in the available evidence.
• To determine medications that interact with lanreotide, further research or consultation of relevant medical literature would be necessary.