Drug Interactions between indium pentetreotide in-111 and pasireotide

ADJUST DOSING INTERVAL: Somatostatin analogs may reduce the accumulation of indium In-111 pentetreotide radioactivity in gastro-entero-neuroendocrine tumors and carcinoid tumors. The sensitivity of the scintigraphy may be reduced. However, in unblinded clinical studies in patients with a high level of suspicion of a neuroendocrine tumor, 87 of the 309 eligible participants had received octreotide within 72 hours of indium In-111 pentreotide administration. In these patients, indium In-111 pentreotide demonstrated a 95% diagnosis success rate; however, the effect of different octreotide doses on this success rate has not been evaluated.

MANAGEMENT: Consideration should be given to temporarily suspending somatostatin analog therapy prior to the administration of indium In-111 pentetreotide. If temporary withdrawal of the somatostatin analog is considered possible, some authorities propose a withdrawal period of three days prior to administration of indium In-111 pentetreotide. Since withdrawal of the somatostatin analog may lead to rebound effects such as hypoglycemia (particularly in patients with insulinoma and carcinoid syndrome), patients should be monitored for any signs of withdrawal.

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