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Drug Interactions between Mycapssa and semaglutide

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

octreotide semaglutide

Applies to: Mycapssa (octreotide) and semaglutide

MONITOR: Somatostatin analogs may alter the therapeutic response to insulin and other antidiabetic agents. Somatostatin analogs can induce hyperglycemia and, less frequently, hypoglycemia, by inhibiting the secretion of various counter-regulatory hormones involved in glucose homeostasis (i.e., glucagon, insulin, growth hormone, incretin hormones). 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 also been reported, primarily 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. Glycemic status including fasting plasma glucose and/or hemoglobin A1c should be assessed prior to initiation of therapy and periodically during therapy in accordance with manufacturer's product labeling, and the antidiabetic treatment adjusted as necessary.

References (9)
  1. Giustina A, Girelli A, Buffoli MG, et al. (1991) "Low-dose octreotide is able to cause a maximal inhibition of the glycemic responses to a mixed meal in obese type 2 diabetic patients treated with insulin." Diabetes Res Clin Pract, 14, p. 47-54
  2. (2001) "Product Information. Sandostatin (octreotide)." Sandoz Pharmaceuticals Corporation
  3. Di Mauro M, Le Moli R, Nicoletti F, Lunetta F (1993) "Effects of octreotide on the glycemic levels in insulin-dependent diabetic patients. Comparative study between administration through multiple subcutaneous injections and continuous subcutaneous infusion." Diabetologia, 36(Suppl 1), A138
  4. Rios MS, Navascues I, Saban J, Ordonez A, Sevilla F, Del Pozo E (1986) "Somatostatin analog SMS 201-995 and insulin needs in insulin-dependent diabetic patients studied by means of an artificial pancreas." J Clin Endocrinol Metab, 63, p. 1071-4
  5. Hadjidakis DJ, Halvatsiotis PG, Ioannou YJ, Mavrokefalos PJ, Raptis SA (1988) "The effects of the somatostatin analogue SMS 201-995 on carbohydrate homeostasis of insulin-dependent diabetics as assessed by the artificial endocrine pancreas." Diabetes Res Clin Pract, 5, p. 91-8
  6. Davies RR, Miller M, Turner SJ, et al. (1986) "Effects of somatostatin analogue SMS 201-995 in non-insulin-dependent diabetes." Clin Endocrinol (Oxf), 25, p. 739-47
  7. Williams G, Fuessl HS, Burrin JM, Chilvers E, Bloom SR (1988) "Postprandial glycaemic effects of a long-acting somatostatin analogue (octreotide) in non-insulin diabetes mellitus." Horm Metab Res, 20, p. 168-70
  8. (2007) "Product Information. Somatuline Depot (lanreotide)." Ipsen Inc
  9. (2013) "Product Information. Signifor (pasireotide)." Novartis Pharmaceuticals

Drug and food interactions

Moderate

octreotide food

Applies to: Mycapssa (octreotide)

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
Moderate

semaglutide food

Applies to: semaglutide

ADJUST DOSING INTERVAL: Taking oral semaglutide with food, beverage, or other oral medications may alter semaglutide absorption and exposure. In a controlled study with healthy volunteers, limited or no measurable semaglutide exposure was observed in subjects that were fed 30 minutes prior to taking oral semaglutide, while all subjects that fasted overnight and 30 minutes after the oral semaglutide dose had measurable semaglutide exposure. Area under the curve (AUC) and semaglutide peak plasma concentration (Cmax) were approximately 40% greater in subjects that fasted compared to those who did not. AUC and Cmax were also increased with a post-dose fasting period greater than 30 minutes.

MANAGEMENT: It is recommended that oral semaglutide be taken 30 minutes before the first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water to ensure its efficacy. Fasting longer than 30 minutes after the oral semaglutide dose may lead to increased gastrointestinal side effects including nausea, vomiting, or diarrhea.

References (4)
  1. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Pharmaceuticals Inc
  2. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Canada Inc
  3. (2024) "Product Information. Rybelsus (semaglutide)." Novo Nordisk Ltd
  4. Baekdal TA, Breitschaft A, Donsmark M, Maarbjerg SJ, Sondergaard FL, Borregaard J (2021) "Effect of various dosing conditions on the pharmacokinetics of oral semaglutide, a human glucagon-like peptide-1 analogue in a tablet formulation" Diabetes Ther, 12, p. 1915-27

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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

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