Octreotide: Uses, Dosage, Side Effects, and Injection Guide

Summary of Key Points

Octreotide is a medication used to manage conditions such as acromegaly, neuroendocrine tumors, and certain gastrointestinal disorders. It works by mimicking somatostatin, a naturally occurring hormone that helps reduce the production of specific chemicals in the body. Octreotide is administered through injections and is available in different forms. Always consult your healthcare provider before starting or adjusting your dose. You can also schedule a telemedicine appointment with one of our providers for personalized care.

Names of Medication

US Brand Name: Sandostatin (Octreotide)

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Octreotide is the generic name, and Sandostatin is the brand name.

Pharmacologic Category

Somatostatin Analog

Other medications in this category include Lanreotide and Pasireotide.

Octreotide Dosing

Octreotide is prescribed for various conditions, and the dosage is tailored to the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also reach out to one of our telemedicine providers for further guidance.

1. Acromegaly: The initial dose is 50 mcg to 100 mcg injected subcutaneously every 8 hours. The dose may be adjusted based on response, up to a maximum of 500 mcg every 8 hours.
2. Carcinoid Syndrome: 100 mcg to 600 mcg injected subcutaneously every 8 to 12 hours. The dose may be adjusted depending on symptom control.
3. VIPoma (Vasoactive Intestinal Peptide Tumor): 200 mcg to 300 mcg injected subcutaneously every 8 to 12 hours. The dose may be increased based on response.
4. Neuroendocrine Tumors: 100 mcg to 600 mcg injected subcutaneously every 8 to 12 hours, with adjustments based on symptom control.
5. Zollinger-Ellison Syndrome: 100 mcg to 600 mcg injected subcutaneously every 8 to 12 hours. The dose may be adjusted based on symptom control.
6. Esophageal Variceal Bleeding: 25 mcg to 50 mcg per hour administered as a continuous intravenous infusion for 2 to 5 days.
7. Pancreatic Cancer: Dosing is individualized based on the patient’s condition and response to treatment. Consult your healthcare provider for specific dosing.
8. Intestinal Fistulas: 100 mcg to 200 mcg injected subcutaneously every 8 to 12 hours. The duration of treatment depends on the patient’s response.
9. Gastroenteropancreatic Neuroendocrine Tumors: 100 mcg to 600 mcg injected subcutaneously every 8 to 12 hours, with adjustments based on symptom control.
10. Cushing’s Disease: Dosing is individualized based on the patient’s condition and response to treatment. Consult your healthcare provider for specific dosing.

Dosage Forms and Strengths

Solution for injection: 50 mcg/mL, 100 mcg/mL, 200 mcg/mL, 500 mcg/mL

Long-acting depot injection (Sandostatin LAR): 10 mg, 20 mg, 30 mg

Administration Instructions for Octreotide

Octreotide is typically administered as an injection, either subcutaneously or intravenously. For subcutaneous injections, it is important to rotate the injection site to prevent irritation. The long-acting depot form (Sandostatin LAR) is usually administered once every 4 weeks by a healthcare provider. Always follow the instructions provided by your healthcare provider or pharmacist. If you have any questions about administering the medication, you can schedule a telemedicine appointment with one of our providers for further guidance.

Contraindications for Octreotide

A contraindication is a condition where a medication should not be used because it may cause harm. If you have any of the following conditions, Octreotide may not be safe for you. Discuss these with your healthcare provider before starting the medication.

1. Allergy to Octreotide: If you are allergic to Octreotide or any of its components, taking this medication could cause a severe allergic reaction, including rash, swelling, or difficulty breathing.
2. Gallbladder disease: Octreotide can reduce gallbladder contractions, increasing the risk of gallstones. If you have a history of gallbladder disease, this medication may worsen your condition.
3. Diabetes: Octreotide can affect blood sugar levels, either raising or lowering them. If you have diabetes, your blood sugar may become more difficult to control while taking this medication.
4. Heart disease: Octreotide can slow your heart rate and may cause irregular heart rhythms. If you have a history of heart disease or arrhythmias, this medication may increase your risk of complications.
5. Thyroid disorders: Octreotide may reduce thyroid function, leading to hypothyroidism. If you have an underactive thyroid or other thyroid issues, this medication could worsen your condition.

Drug-to-Drug Interactions with Octreotide

Octreotide may interact with other medications, increasing the risk of side effects or reducing the effectiveness of one or both drugs. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Key drug interactions include:

1. Insulin and oral diabetes medications: Octreotide can affect blood sugar levels, so it may interact with insulin or medications like Metformin (Glucophage) or Glyburide (Diabeta), requiring close monitoring of blood sugar levels.
2. Beta-blockers: Medications like Metoprolol (Lopressor) or Atenolol (Tenormin) can slow the heart rate, and when combined with Octreotide, the risk of bradycardia (slow heart rate) may increase.
3. Calcium channel blockers: Drugs like Amlodipine (Norvasc) can also affect heart rate and blood pressure. When taken with Octreotide, there may be an increased risk of low blood pressure or heart rhythm problems.
4. Cyclosporine (Neoral, Sandimmune): Octreotide may reduce the absorption of Cyclosporine, a medication used to prevent organ transplant rejection, potentially lowering its effectiveness.
5. Bromocriptine (Parlodel): Octreotide can increase the absorption of Bromocriptine, a medication used to treat conditions like Parkinson’s disease and acromegaly, which may increase the risk of side effects.

Octreotide in Pregnancy

Is it safe to take Octreotide when pregnant?

There is limited information on the safety of Octreotide during pregnancy. While animal studies have not shown harm to the fetus, no well-controlled studies have been conducted in pregnant women. Octreotide should only be used if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it’s important to discuss the risks and benefits of Octreotide therapy with your healthcare provider. Our telemedicine providers are available to help you make an informed decision.

Octreotide While Breastfeeding

Is it safe to take Octreotide while breastfeeding?

It is not known whether Octreotide passes into breast milk. Due to the lack of available data, caution is advised when using Octreotide medication while breastfeeding. Be sure to discuss the potential risks and benefits with your healthcare provider before deciding whether to continue breastfeeding while on this medication. Our telemedicine providers can guide you in making the best decision for both you and your baby.

Estimated Cost of Octreotide Medication

The estimated cost of a 30-day supply of Octreotide without insurance can vary depending on the dosage and the pharmacy. With a GoodRx coupon, the cost typically ranges from $1,500 to $3,000. For the most accurate pricing, check with your pharmacy and explore available discount options. If you’re concerned about the Octreotide cost, our telemedicine providers can assist you in exploring financial assistance programs or alternative treatments.

Possible Alternatives to Octreotide

If Octreotide is not suitable for you, or if you’re looking for alternative treatments, there are other options available depending on the condition being treated. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers can help you explore these alternatives.

1. Acromegaly: Alternatives include Pegvisomant (Somavert) or Cabergoline (Dostinex). Surgery or radiation therapy may also be considered. While Octreotide for acromegaly treatment is common, these alternatives may be appropriate in certain cases.
2. Carcinoid syndrome: Lanreotide (Somatuline) is another somatostatin analog that may be used. Dietary changes, such as avoiding foods that trigger symptoms, can also help manage this condition. Although Octreotide for carcinoid syndrome is effective, alternatives like Lanreotide may be worth considering.
3. VIPoma: Treatment options may include chemotherapy or medications like Lanreotide (Somatuline). Surgery to remove the tumor may also be an option.
4. Neuroendocrine tumors: Alternatives include Lanreotide (Somatuline) or targeted therapies such as Everolimus (Afinitor). Surgery and radiation therapy may also be considered depending on the tumor’s characteristics.
5. Zollinger-Ellison syndrome: Proton pump inhibitors (PPIs) like Omeprazole (Prilosec) or Esomeprazole (Nexium) can help reduce stomach acid production. Surgery to remove the tumor may also be an option.
6. Esophageal variceal bleeding: Endoscopic therapy or medications like Propranolol (Inderal) may help manage this condition. In severe cases, surgery may be necessary.
7. Pancreatic cancer: Treatment options include chemotherapy, radiation, or surgery. Depending on the stage of the cancer, targeted therapies and immunotherapy may also be considered.
8. Intestinal fistulas: Treatment may involve nutritional support, antibiotics, or surgery, depending on the severity of the condition.
9. Gastroenteropancreatic neuroendocrine tumors: Alternatives include Lanreotide (Somatuline) or targeted therapies like Sunitinib (Sutent). Surgery may also be an option depending on the tumor’s location and size.
10. Cushing’s disease: Medications like Ketoconazole or Metyrapone may help reduce cortisol production. Surgery to remove the tumor causing the condition may also be considered.

Recent Updates on Octreotide Research

Recent studies continue to explore the use of Octreotide in treating neuroendocrine tumors and hormone-related conditions. One area of ongoing research is the development of long-acting formulations of Octreotide injection to improve patient compliance and reduce the frequency of injections. Additionally, researchers are investigating the potential of Octreotide in combination with other therapies, such as targeted treatments or immunotherapy, to enhance its effectiveness in managing conditions like neuroendocrine tumors and pancreatic cancer.

New research is also examining the role of Octreotide in managing complications from gastrointestinal bleeding, particularly in patients with liver disease. These studies aim to refine dosing strategies and identify which patients are most likely to benefit from treatment. As research continues to evolve, staying informed about new developments is important. Our telemedicine providers can help you understand how the latest research may impact your treatment options.

James Kingsley

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