Octreotide

Patient with insulinomas, diabetes mellitus; heart failure, conditions which cause excessive fluid loss; history of vitamin B₁₂ deprivation; liver cirrhosis. Renal and hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor hepatic function; serum GH and IGF-1 (in acromegaly); urinary 5-hydroxyindole acetic acid (5-HIAA), plasma serotonin and plasma substance P (in carcinoid tumours); plasma VIP (in VIPomas). Assess for signs of tumour expansion (e.g. visual field defects). Chronic treatment: Monitor thyroid function (e.g. TSH, total and/or free T₄) at baseline and periodically; cardiac function (e.g. ECG, heart rate), vitamin B₁₂ levels; blood glucose and glycaemic control (in diabetic patients); zinc level (in patients with excessive fluid loss maintained on TPN). Perform gallbladder monitoring and ultrasound examination as necessary.

Significant: Bradycardia, conduction abnormalities, arrhythmia; impaired gallbladder function causing cholelithiasis and its related complications (e.g. cholecystitis, cholangitis, pancreatitis); hypoglycaemia, hyperglycaemia, hypothyroidism. Blood and lymphatic system disorders: Hyperbilirubinaemia. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain, abdominal bloating, constipation, flatulence, dyspepsia, loose stools, steatorrhoea, discolourations of faeces. General disorders and administration site conditions: Injection site pain, asthenia. Investigations: Elevated transaminases; decreased TSH, total and free T₄. Metabolism and nutrition disorders: Anorexia, impaired glucose tolerance. Nervous system disorders: Headache, dizziness. Respiratory, thoracic and mediastinal disorders: Dyspnoea. Skin and subcutaneous tissue disorders: Pruritus, rash, alopecia.

May impair insulin secretion; dosage adjustments of insulins and other antidiabetic medications may be required. Decreased intestinal absorption of ciclosporin. Delayed intestinal absorption of cimetidine. Increased bioavailability of bromocriptine. May cause additive bradycardia; dose adjustment of β-blockers, Ca channel blockers, or drugs that control fluid and electrolyte balance may be necessary.

Other Gastrointestinal Drugs / Trophic Hormones & Related Synthetic Drugs

H01CB02 - octreotide ; Belongs to the class of antigrowth hormone. Used in hypothalamic hormone preparations.