Octreotide and Cyclosporine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cyclosporine
Octreotide
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced cycloSPORINE exposure and reduced efficacy of cycloSPORINE
Interaction Deep Dive
Concomitant use of cycloSPORINE and octreotide may decrease cycloSPORINE bioavailability2 and blood levels, and may result in transplant rejection 13. In a single-dose study, coadministration of cycloSPORINE 300 mg and octreotide 20 mg orally significantly decreased cycloSPORINE AUC by 62% and Cmax by 71% 2. If concomitant use is required, adjust cycloSPORINE dose as needed to maintain therapeutic levels 24.
Why it happens (mechanism)
Reduced cycloSPORINE absorption
Literature reports
2 reports — tap to read
a) In a single-dose study, coadministration of cycloSPORINE 300 mg and octreotide 20 mg orally significantly decreased cycloSPORINE AUC by 62% (mean ratio, 0.38; 90% CI, 0.31 to 0.46) and Cmax by 71% (mean ratio, 0.29; 90% CI, 0.22 to 0.37) 2.
b) A study reported a case in which a 36-year old man experienced an adverse interaction between octreotide and cycloSPORINE. The patient was receiving cycloSPORINE 6 mg per kg daily in addition to predniSONE and antilymphocyte immunoglobulins as an immunosuppressive regimen for kidney and pancreas transplantation. A leak was detected that later developed into a fistula. Octreotide (SMS 201-995) 50 mcg twice daily subcutaneously was begun due to persistence of the fistula drainage. Within 48 hours of octreotide administration, fistula drainage decreased approximately 98%. However, while the patient received octreotide, cycloSPORINE trough levels slowly decreased, despite an increase in cycloSPORINE dose from 180 mg to 300 mg per day. After the cycloSPORINE level fell below 100 ng/mL, intravenous cycloSPORINE was begun. The patient developed symptoms of graft rejection and an increase in serum creatinine 46 days after transplantation. After discontinuation of octreotide and the initiation of pulse steroid therapy, the graft rejection episode was reversed and cycloSPORINE blood levels were restored. The authors postulated that octreotide inhibited cycloSPORINE absorption by inhibiting or delaying fat absorption in the intestine. However, the difficulty encountered in reestablishing therapeutic cycloSPORINE drug levels when the drug was given intravenously may have been caused by octreotide preventing the reabsorption of excreted drug 5.
Common questions
Can I take Octreotide and Cyclosporine together?
Reduced cycloSPORINE exposure and reduced efficacy of cycloSPORINE Always confirm with your pharmacist or prescriber before making any change.
How serious is the Octreotide and Cyclosporine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Octreotide or Cyclosporine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (5)
- Product Information: BYNFEZIA PEN(TM) subcutaneous injection, octreotide acetate subcutaneous injection. Sun Pharmaceutical Industries Inc (per FDA), Cranbury, NJ, 2020. DailyMed
- Product Information: MYCAPSSA(R) oral delayed-release capsules, octreotide oral delayed-release capsules. Chiasma Inc (per manufacturer), Cincinnati, OH, 2020. DailyMed
- Product Information: SANDOSTATIN(R) LAR DEPOT intramuscular injection suspension, octreotide acetate intramuscular injection suspension. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2019.
- Product Information: SANDIMMUNE(R) oral capsules, oral solution, intravenous injection, cyclosporine oral capsules, oral solution, intravenous injection. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- Rosenberg L, Dafoe DC, Schwartz R, et al: Administration of somatostatin analog (SMS 201-995) in the treatment of a fistula occurring after pancreas transplantation. Transplantation 1987; 43:764-766. DOI
Keep reading about Cyclosporine
Keep reading about Octreotide
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