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
Lanreotide interacts with the following medications:
- 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 1
- Cyclosporine: lanreotide may decrease the absorption of cyclosporine, necessitating adjustment of cyclosporine dose 1 1
- Bromocriptine: lanreotide may increase the absorption of bromocriptine 1 1
- Bradycardia-inducing drugs (e.g., beta-blockers): lanreotide may have an additive effect on the reduction of heart rate, requiring dosage adjustments of concomitant drugs 1 1
- Drugs metabolized by CYP3A4 with a low therapeutic index (e.g., quinidine, terfenadine): lanreotide may decrease the metabolic clearance of these compounds, requiring avoidance or dose reduction 1
From the Research
Lanreotide interacts with several medications, including cyclosporine, beta-blockers, antidiabetic medications, and drugs that prolong the QT interval, requiring monitoring or dosage adjustments to minimize potential adverse effects. When considering the interactions of lanreotide with other medications, it is crucial to prioritize the most recent and highest quality evidence to ensure optimal patient outcomes in terms of morbidity, mortality, and quality of life. The most recent study 2 highlights the safety profile of lanreotide, indicating that it is well-tolerated with low rates of treatment discontinuation due to toxicity, but it does not specifically address drug interactions. However, based on the available evidence, lanreotide can:
- Decrease the absorption of orally administered drugs taken concurrently, particularly cyclosporine
- Enhance the effects of beta-blockers like propranolol and metoprolol, potentially causing excessive bradycardia
- Affect blood glucose levels, requiring adjustment of antidiabetic medications such as insulin, sulfonylureas, and metformin
- Increase the risk of cardiac arrhythmias when used with drugs that prolong the QT interval, such as certain antiarrhythmics, antipsychotics, and antibiotics like moxifloxacin
- Reduce the effectiveness of bromocriptine
- Alter the metabolism of drugs processed by certain liver enzymes, potentially affecting their blood levels It is essential for patients to inform their healthcare providers about all medications they are taking before starting lanreotide therapy, and regular monitoring is necessary when these combinations cannot be avoided, as supported by studies such as 3, 4, 5, and 6.