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Interactions between Lanreotide and Lutathera

1 drug interaction and 13 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

lanreotide lutetium Lu 177 dotatate

Applies to: lanreotide and Lutathera (lutetium lu 177 dotatate)
Adjust dosing interval

Somatostatin and its analogs may interfere with the therapeutic effects of lutetium Lu 177 dotatate by competitively binding to somatostatin receptors, the site of action for the radiolabeled agent. Lutetium Lu 177 dotatate is internalized upon binding to somatostatin receptor expressing cells, including malignant somatostatin receptor-positive tumor cells, and subsequent beta emission from Lu 177 induces cellular damage by formation of free radicals in both target and neighboring cells.

Management

Long-acting formulations of somatostatin analogs should be discontinued for at least 4 weeks and short-acting formulations for at least 24 hours prior to each dose of lutetium Lu 177 dotatate. During treatment with lutetium Lu 177 dotatate, long-acting octreotide should be administered intramuscularly between 4 to 24 hours after each dose of lutetium Lu 177 dotatate (but not within 4 weeks of each subsequent dose of lutetium Lu 177 dotatate), while short-acting octreotide may be given as needed for symptomatic management (but not within 24 hours before each subsequent dose of lutetium Lu 177 dotatate). Following completion of lutetium Lu 177 dotatate treatment, long-acting octreotide should be continued every 4 weeks until disease progression or up to 18 months following treatment initiation.

References (1)
  1. (2025) "Product Information. Lutathera (lutetium Lu 177 dotatate)." Advanced Accelerator Applications

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

lanreotide Food/Lifestyle

Applies to: lanreotide
Monitor

Due to their gastrointestinal pharmacologic effects, somatostatin analogs (e.g., octreotide, lanreotide) may variously affect the absorption of dietary nutrients and concomitantly administered oral medications. Somatostatin analogs have been shown to prolong gastrointestinal transit time and inhibit intestinal absorption of some nutrients such as fat. Clinical data are limited, however. In case reports, octreotide has been reported to reduce the relative bioavailability of cyclosporine. Transplant rejection and significant reductions in cyclosporine levels, sometimes to undetectable levels, have been reported in association with the interaction. Vitamin K absorption was not affected when concomitantly administered with lanreotide according to the manufacturer.

Management

Clinicians should be aware of the potential for altered absorption of concomitantly administered oral medications during treatment with somatostatin analogs. Blood levels and clinical response should be monitored, particularly for drugs that have a narrow therapeutic index, and the dosages adjusted as necessary.

References (5)
  1. Landgraf R, Landgraf-Leurs MM, Nusser J, et al. (1987) "Effect of somatostatin analogue (SMS201-995) on cyclosporine levels." Transplantation, 44, p. 724-5
  2. Ho PJ, Boyajy LD, Greenstein E, Barkan AL (1993) "Effect of chronic octreotide treatment on intestinal absorption in patients with acromegaly." Dig Dis Sci, 38, p. 309-15
  3. Katz MD, Erstad BL (1989) "Octreotide, a new somatostatin analogue." Clin Pharm, 8, p. 255-73
  4. (2001) "Product Information. Sandostatin (octreotide)." Sandoz Pharmaceuticals Corporation
  5. (2007) "Product Information. Somatuline Depot (lanreotide)." Ipsen Inc

Disease interactions

12 potential interactions Applies to: 10 conditions, including Underactive Thyroid, Heart Disease, Diabetes Mellitus, Gallbladder Disease, and Thyroid Disease.

Adrenal Insufficiency

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Adrenal Insufficiency.

Treatment with somatostatin analogs may suppress the pituitary hormones other than GH/IGF-1. It is recommended to monitor pituitary function prior to initiation of therapy and periodically during treatment, as clinically appropriate. Patients should be monitored for and instructed on the signs and symptoms of adrenal insufficiency during therapy. If adrenal insufficiency is suspected it should be confirmed and treated per standard of care with exogenous glucocorticoids at replacement doses.

Bone Marrow Depression/Low Blood Counts

Moderate:

Lutathera

The lutetium Lu 177 dotatate in Lutathera has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of lutetium Lu 177 dotatate may increase the risk of developing myelosuppression. Care should be exercised when using this agent in immunocompromised patients. It is recommended to monitor blood cell counts. Withhold, reduce dose, or permanently discontinue based on severity of adverse reaction.

Diabetes Mellitus

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Diabetes Mellitus.

Elevations in blood glucose levels have been reported with the use of somatostatin analogs. Cushing's disease patients with poor glycemic control may be at a higher risk of developing severe hyperglycemia and associated complications, e.g., ketoacidosis. It is recommended to assess the glycemic status of hemoglobin A1C prior to starting treatment with these agents. Self-monitoring of blood glucose and/or FPG assessments should be done every week for the first two to three months and periodically thereafter, as clinically appropriate, as well as over the first two to four weeks after any dose increase. If uncontrolled hyperglycemia persists, despite appropriate medical management, the dose of these agents should be reduced or discontinued.

Gallbladder Disease

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Gallbladder Disease.

Somatostatin analogs may reduce gallbladder motility and lead to gallstones formation. It is recommended to assess the gallbladder prior to starting therapy and periodically thereafter.

Heart Disease

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Heart Disease.

Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.

Immunodeficiency

Moderate:

Lutathera

The lutetium Lu 177 dotatate in Lutathera has a moderate potential interaction with Immunodeficiency.

The use of lutetium Lu 177 dotatate may increase the risk of developing myelosuppression. Care should be exercised when using this agent in immunocompromised patients. It is recommended to monitor blood cell counts. Withhold, reduce dose, or permanently discontinue based on severity of adverse reaction.

Liver Disease

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Liver Disease.

In clinical trials, a reduced clearance of lanreotide was observed in subjects with moderate to severe hepatic impairment. Patients with moderate to severe hepatic impairment should begin treatment with lanreotide 60 mg. Caution should be exercised when using this agent in patients with moderate or severe hepatic impairment for an extended dosing interval.

Moderate:

Lutathera

The lutetium Lu 177 dotatate in Lutathera has a moderate potential interaction with Liver Disease.

Lutetium Lu 177 dotatate does not undergo hepatic metabolism. No dose adjustment is recommended for patients with mild or moderate hepatic impairment. Care is recommended when using lutetium Lu 177 dotatate in patients with severe hepatic impairment (total bilirubin > 3 times upper limit of normal and any AST) as its safety has not been studied in these patients. Monitor transaminases, bilirubin and serum albumin during treatment.

Renal Dysfunction

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Renal Dysfunction.

Lanreotide has not been studied in patients with mild, moderate and severe renal failure. It is recommended to start patients with moderate and severe renal impairment at a lower dose as clinically appropriate.

Moderate:

Lutathera

The lutetium Lu 177 dotatate in Lutathera has a moderate potential interaction with Renal Dysfunction.

Lutetium Lu 177 dotatate predominantly undergoes renal excretion. No dose adjustment is recommended for patients with mild to moderate renal impairment. It is recommended to assess renal function frequently in patients with mild to moderate impairment during therapy with this agent. . Monitor serum creatinine and calculated creatinine clearance. The safety of lutetium Lu 177 dotatate in patients with severe renal impairment or end-stage renal disease has not been studied

Thyroid Disease

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Thyroid Disease.

Slight decreases in thyroid function have been seen during treatment with lanreotide. Care should be taken when using this agent in patients with thyroid dysfunctions and it is recommended to monitor thyroid function where clinically indicated.

Underactive Thyroid

Moderate:

lanreotide

Lanreotide has a moderate potential interaction with Underactive Thyroid.

Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.

More resources

lanreotide

A total of 231 drugs are known to interact with lanreotide.

Lutathera

A total of 248 drugs are known to interact with Lutathera.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.