Interactions between octreotide and Apidra opticlik cartridge (insulin glulisine)
octreotide and insulin glulisine (Moderate Drug-Drug)
MONITOR: Somatostatin analogs (e.g., octreotide, lanreotide) may alter the therapeutic response to insulin and oral hypoglycemic agents. Somatostatin analogs can induce hypo- or hyperglycemia by inhibiting the secretion of various counter-regulatory hormones involved in glucose homeostasis (i.e., glucagon, insulin, growth hormone). Although the cases of hypo- or hyperglycemia associated with somatostatin analog therapy are usually mild, overt diabetes and dose change requirements in insulin or oral antidiabetic therapy have been reported. One patient with no history of hyperglycemia developed severe hyperglycemia followed by pneumonia and subsequently died after initiation of octreotide therapy. Severe, symptomatic hypoglycemia has been reported in patients with type I diabetes mellitus. Octreotide has been associated with 50% reductions in blood glucose levels and/or insulin requirements in some insulin-dependent patients.
MANAGEMENT: Close monitoring of diabetic control is recommended if somatostatin analogs are prescribed to patients with preexisting diabetes. In patients with type I diabetes mellitus, somatostatin analogs are likely to affect glucose regulation and may reduce insulin or oral hypoglycemic requirements. In type II diabetics with partially intact insulin reserves, decreased plasma insulin levels and hyperglycemia may occur. Glucose tolerance and antidiabetic treatment should be periodically monitored during therapy with somatostatin analogs.
