Somatuline Autogel Drug Interactions

Associations requiring precautions for use: Cyclosporine (oral use): Decrease in cyclosporine blood levels (decrease in the intestinal cyclosporine absorption). Increase the cyclosporine dose under the control of circulating blood levels and reduce of doses after stopping lanreotide treatment.
Insulin, glitazones, repaglinide, sulphonylureas: Risk of hypoglycaemia or hyperglycaemia: decrease in the needs of antidiabetic treatment following decrease or increase in endogen glucagon secretion.
The glycaemic self monitoring must be reinforced and the posology of antidiabetic treatment during treatment by lanreotide should be adapted as required.
Concomitant administration of bradycardia inducing drugs (e.g. beta blockers) may have an additive effect on the slight reduction of heart rate associated with lanreotide. Dose adjustments of such concomitant medications may be necessary (see Precautions).
The limited published data available indicate that somatostatin analogues may decrease the metabolic clearance of compounds known to be metabolised by cytochrome P450 enzymes, which may be due to the suppression of growth hormone. Since it cannot be excluded that lanreotide may have this effect, other drugs mainly metabolized by CYP3A4 and which have a low therapeutic index (e.g. quinidine) should therefore be used with caution.
Other information: Interactions with highly plasma bound drugs are unlikely in view of the moderate binding of lanreotide to serum proteins.