Octreotide Acetate(ok tree’ oh tide)
Sandostatin, Sandostatin LAR Depot
PREGNANCY CATEGORY B
Drug Classes
Antidiarrheal
Hormone
Therapeutic Actions
Mimics the natural hormone somatostatin; suppresses secretion of serotonin, gastrin, vasoactive intestinal peptide, insulin, glucagon, secretin, motilin, and pancreatic polypeptide; also suppresses growth hormone and decreases splanchnic blood flow.
Indications
Symptomatic treatment of patients with metastatic carcinoid tumors to suppress or inhibit the associated severe diarrhea and flushing episodes
Treatment of the profuse watery diarrhea associated with vasoactive intestinal polypeptide tumors (VIPomas)
Reduction of growth hormone blood levels in patients with acromegaly not responsive to other treatment
Unlabeled uses: GI fistula, variceal bleeding, diarrheal states, pancreatic fistulas, IBS, dumping syndrome
Contraindications and Cautions
Contraindicated with hypersensitivity to octreotide or any of its components.
Use cautiously with renal impairment, thyroid disease, diabetes mellitus, pregnancy, lactation.
Available Forms
Injection—0.05, 0.1, 0.2, 0.5, 1 mg/mL; depot injection—10, 20, 30 mg/5 mL
Dosages
Adults
Subcutaneous injection is the route of choice. Initial dose is 50 mcg subcutaneously two to three times daily; the number of injections is increased based on response, usually bid–tid. IV bolus injections have been used in emergency situations—not recommended. Depot injection: Do not administer IV or subcutaneously; inject intragluteally at 4-wk intervals. Patients should be stabilized on subcutaneous octreotide for at least 2 wk before switching to long-acting depot.
Carcinoid tumors: First 2 wk of therapy: 100–600 mcg/day subcutaneously in two to four divided doses (mean daily dosage, 300 mcg).
VIPomas: 200–300 mcg subcutaneously in two to four divided doses during initial 2 wk of therapy to control symptoms. Range, 150–750 mcg subcutaneously; doses above 450 mcg are usually not required. Depot injection: 20 mg IM every 4 wk.
Acromegaly: 50 mcg tid subcutaneously, adjusted up to 100–500 mcg tid. Withdraw for 4 wk once yearly. Depot injection: 20 mg IM intragluteally once every 4 wk; after 2–3 mo, re-evaluate patient to adjust dosage as needed.
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