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Drug Interactions between Signifor LAR and Symlin Pen

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

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Interactions between your drugs

Moderate

pramlintide pasireotide

Applies to: Symlin Pen (pramlintide) and Signifor LAR (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. (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
View all 9 references

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Drug and food interactions

Moderate

pramlintide food

Applies to: Symlin Pen (pramlintide)

ADJUST DOSING INTERVAL: Pramlintide slows gastric emptying and may delay the absorption of concomitantly administered oral medications. In a pharmacokinetic study of 24 patients with type 2 diabetes, coadministration with pramlintide (120 mcg) decreased the peak plasma concentration (Cmax) of acetaminophen (1000 mg) by 29% and increased its time to peak plasma concentration (Tmax) based on the time of acetaminophen administration relative to pramlintide injection. Pramlintide significantly increased acetaminophen Tmax (range 48 to 72 minutes) when acetaminophen was administered simultaneously with or up to 2 hours following pramlintide injection, but it had negligible effect when acetaminophen was administered 1 to 2 hours before pramlintide injection.

MANAGEMENT: When rapid onset of a concomitantly administered oral medication is critical to its effectiveness, the medication should be administered at least 1 hour before or 2 hours after pramlintide injection.

References

  1. (2005) "Product Information. Symlin (pramlintide)." Amphastar Pharmaceuticals Inc

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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.

Further information

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