Octreotide


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Variceal haemorrhage in patients w/ cirrhosis 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding). IM Acromegaly Following initial control w/ SC therapy: Depot Initial: 20 mg 4 wkly. Adjust if required after 3 mth to 10-30 mg 4 wkly. Max: 40 mg 4 wkly. IM/SC Secretory neoplasms As SC: Initial: 50 mcg 1-2 times/day, up to 600 mcg/day in 2-4 divided doses based on response. Maintenance: Depot 10-30 mg 4 wkly via IM inj. SC Acromegaly Initial: 50 mcg 3 times/day, increase if needed. Usual dose: 100-200 mcg 3 times/day. Max: 500 mcg 3 times/day. Prevention of complications following pancreatic surgery 100 mcg 3 times/day of a rapid-acting preparation for 7 days, starting at least 1 hr pre-op. HIV-associated diarrhoea Initial: 100 mcg 3 times/day. If symptoms are not controlled after 1 wk, increase to 250 mcg 3 times/day. Secretory neoplasms Initial: 50 mcg 1-2 times/day, up to 600 mcg/day in 2-4 divided doses based on response.
Dosage Details
Intramuscular
Acromegaly
Adult: Following initial control with SC therapy: As a depot preparation, initially 20 mg every 4 wk. Adjust if required after 3 mth to 10-30 mg every 4 wk. Max: 40 mg every 4 wk.

Intravenous
Variceal haemorrhage in patients with cirrhosis
Adult: As continuous IV infusion: 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding).
Child: ≥1 mth: 1 mcg/kg/hr (up to 50 mcg/hr); given as continuous IV infusion. Higher doses may be needed initially, reduce dose gradually over 24 hr until bleeding has stopped.

Subcutaneous
Prophylaxis of complications following pancreatic surgery
Adult: 100 mcg tid of a rapid-acting preparation given for 7 consecutive days, starting at least 1 hr before operation.

Subcutaneous
Acromegaly
Adult: Initially 50 mcg tid, increased as necessary to usual dose 100-200 mcg tid. Max: 500 mcg tid.

Subcutaneous
Secretory neoplasms
Adult: Initially, 50 mcg 1-2 times daily, increased gradually to up to 600 mcg daily in 2-4 divided doses according to response. Continued treatment is not recommended if there is no benefit within a wk of starting treatment for carcinoid tumour. Initial dose may be given via IV admin of a rapid response is required.

Subcutaneous
HIV-associated diarrhoea
Adult: Initial dose 100 mcg tid. If symptoms are not controlled after 1 wk, increase dose to 250 mcg tid, if still not effective after 1 wk stop therapy.
Renal Impairment
Dosage may need to be reduced in severe renal impairment requiring dialysis.
Incompatibility
Intravenous:
Incompatible with most TPN solutions due to formation of a glycosyl octreotide conjugate, which may decrease efficacy.
Subcutaneous:
Secretory neoplasms: Incompatible with most TPN solutions due to formation of a glycosyl octreotide conjugate, which may decrease efficacy.
Special Precautions
Renal disease; risk of gall bladder disease; DM; hypothyroidism. Pregnancy, lactation, children, elderly. Monitor levels of vitamin B12 during long term therapy.
Adverse Reactions
Local pain, stinging, tingling at site of inj; anorexia, nausea, vomiting, abdominal pain, bloating, flatulence, loose stools, steatorrhoea; biliary tract abnormalities. Hypoglycaemia and hyperglycaemia, hypothyroidism, cardiac conduction abnormalitles, pancreatitis.
IM/IV/Parenteral/SC: B
Drug Interactions
Dosage adjustment of concurrent therapy may be necessary with calcium channel blockers, oral hypoglycaemics, β-blockers, diuretics. May increase concentration of bromocriptine.
Potentially Fatal: Requirements of insulin may be reduced requiring careful blood-glucose monitoring. Reduction in ciclosporin bioavailability and efficacy.
Food Interaction
Schedule injections between meals to decrease adverse GI effects.
Action
Description: Octreotide is a synthetic analogue of somatostatin which acts by suppressing basal and stimulated secretion of growth hormone (GH). It also suppresses LH response to gonadotrophin-releasing hormone and reduces the secretion of gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin and pancreatic polypeptide.
Pharmacokinetics:
Absorption: Rapidly absorbed (SC); peak plasma concentrations after 25-30 min.
Distribution: 65% plasma protein bound.
Excretion: Via urine (as unchanged); 1.5 hr (elimination half-life), prolonged in elderly.
Storage
Store at 2-8°C. Stable at room temperature for up to 14 days.
Disclaimer: This information is independently developed by MIMS based on Octreotide from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Sandostatin
  • Sandostatin LAR
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in