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Drug Interactions between Oseni and pasireotide

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

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Moderate

pioglitazone pasireotide

Applies to: Oseni (alogliptin / pioglitazone) and pasireotide

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

  1. Giustina A, Girelli A, Buffoli MG, et al. "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 (1991): 47-54
  2. "Product Information. Sandostatin (octreotide)." Sandoz Pharmaceuticals Corporation PROD (2001):
  3. Di Mauro M, Le Moli R, Nicoletti F, Lunetta F "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) (1993): A138
  4. Rios MS, Navascues I, Saban J, Ordonez A, Sevilla F, Del Pozo E "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 (1986): 1071-4
  5. Hadjidakis DJ, Halvatsiotis PG, Ioannou YJ, Mavrokefalos PJ, Raptis SA "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 (1988): 91-8
  6. Davies RR, Miller M, Turner SJ, et al. "Effects of somatostatin analogue SMS 201-995 in non-insulin-dependent diabetes." Clin Endocrinol (Oxf) 25 (1986): 739-47
  7. Williams G, Fuessl HS, Burrin JM, Chilvers E, Bloom SR "Postprandial glycaemic effects of a long-acting somatostatin analogue (octreotide) in non-insulin diabetes mellitus." Horm Metab Res 20 (1988): 168-70
  8. "Product Information. Somatuline Depot (lanreotide)." Ipsen Inc (2007):
  9. "Product Information. Signifor (pasireotide)." Novartis Pharmaceuticals (2013):
View all 9 references

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Moderate

pasireotide alogliptin

Applies to: pasireotide and Oseni (alogliptin / pioglitazone)

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

  1. Giustina A, Girelli A, Buffoli MG, et al. "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 (1991): 47-54
  2. "Product Information. Sandostatin (octreotide)." Sandoz Pharmaceuticals Corporation PROD (2001):
  3. Di Mauro M, Le Moli R, Nicoletti F, Lunetta F "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) (1993): A138
  4. Rios MS, Navascues I, Saban J, Ordonez A, Sevilla F, Del Pozo E "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 (1986): 1071-4
  5. Hadjidakis DJ, Halvatsiotis PG, Ioannou YJ, Mavrokefalos PJ, Raptis SA "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 (1988): 91-8
  6. Davies RR, Miller M, Turner SJ, et al. "Effects of somatostatin analogue SMS 201-995 in non-insulin-dependent diabetes." Clin Endocrinol (Oxf) 25 (1986): 739-47
  7. Williams G, Fuessl HS, Burrin JM, Chilvers E, Bloom SR "Postprandial glycaemic effects of a long-acting somatostatin analogue (octreotide) in non-insulin diabetes mellitus." Horm Metab Res 20 (1988): 168-70
  8. "Product Information. Somatuline Depot (lanreotide)." Ipsen Inc (2007):
  9. "Product Information. Signifor (pasireotide)." Novartis Pharmaceuticals (2013):
View all 9 references

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Drug and food interactions

Moderate

pioglitazone food

Applies to: Oseni (alogliptin / pioglitazone)

GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

MANAGEMENT: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

References

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72
  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
View all 10 references

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Moderate

alogliptin food

Applies to: Oseni (alogliptin / pioglitazone)

GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

MANAGEMENT: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

References

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72
  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
View all 10 references

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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.

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