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Octreotide

Brand and Other Names: Sandostatin
Mechanism of Action:
Octreotide exerts pharmacologic actions similar to the natural hormone, somatostatin. It is an even more potent inhibitor of growth hormone, glucagon, and insulin than somatostatin. Like somatostatin, it also suppresses LH response to GnRH, decreases splanchnic blood flow, and inhibits release of serotonin, gastrin, vasoactive intestinal peptide, secretin, motilin, and pancreatic polypeptide. By virtue of these pharmacological actions, octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea), and VIP secreting adenomas (watery diarrhea).
Indications:

SANDOSTATIN LAR DEPOT is a somatostatin analogue indicated for: Treatment in patients who have responded to and tolerated Sandostatin Injection subcutaneous injection for:
•Acromegaly.
•Severe diarrhea/flushing episodes associated with metastatic carcinoid tumors.
•Profuse watery diarrhea associated with Vasoactive Intestinal Peptide (VIP) secreting tumors.

Route: Intramuscular
Dose:

Patients not currently receiving Sandostatin Injection subcutaneously:
•Acromegaly: 50 mcg three times daily Sandostatin Injection subcutaneously for 2 weeks followed by SANDOSTATIN LAR DEPOT 20 mg intragluteally every 4 weeks for 3 months.
•Carcinoid Tumors and VIPomas: Sandostatin Injection subcutaneously 100-600 mcg/day in 2-4 divided doses for 2 weeks followed by SANDOSTATIN LAR DEPOT 20 mg every 4 weeks for 2 months. See package insert for complete information.

Adverse Reactions:

The most common adverse reactions, occurring in ≥ 20% of patients are:
•Acromegaly: diarrhea, cholelithiasis, abdominal pain, flatulence.
•Carcinoid Syndrome: back pain, fatigue, headache, abdominal pain, nausea, dizziness.

Contraindication:
None.
Warnings and Precautions:

• Cholelithiasis and Complications of Cholelithiasis. Monitor periodically. Discontinue if complications of cholelithiasis are suspected. •Glucose Metabolism: Hypoglycemia or hyperglycemia may occur. Glucose monitoring is recommended and antidiabetic treatment may need adjustment.
•Thyroid Function: Hypothyroidism may occur. Monitor thyroid levels periodically.
•Cardiac Function: Bradycardia, arrhythmia, or conduction abnormalities may occur. Use with caution in at-risk patients.

See package insert for full prescribing information.