Sandostatin

Indications

Octreotide is a man-made version of somatostatin, a natural hormone that switches off the release of several other hormones. It is used to treat acromegaly (excess growth hormone), and to control severe diarrhoea and flushing caused by certain hormone-producing tumours of the gut and pancreas (carcinoid tumours and VIPomas). Doctors may also use it in hospital for bleeding from swollen veins in the food pipe and for some pancreas and bowel problems.

How It Works

It attaches to somatostatin receptors and reduces the release of growth hormone, insulin, glucagon and several gut hormones. This lowers hormone excess, reduces fluid secretion in the gut and decreases blood flow to the gut organs.

Dosage and Administration

It is given by injection, either under the skin or into a vein, and long-acting forms are injected into a muscle once a month. Injections are given by a doctor or nurse, or by the patient at home after proper training. The dose depends on the condition and is given as prescribed, adjusted according to symptoms and blood tests.

Interactions

It can reduce the absorption of Ciclosporin and alter blood sugar control, so insulin or diabetes tablet doses may need changing. It may slow the heart when used with beta blockers or calcium channel blockers. It can affect the levels of Bromocriptine and some medicines broken down in the liver.

Contraindications

• Allergy to Octreotide or any ingredient of the injection

Side Effects

Common effects include stomach pain, nausea, wind, loose or fatty stools, pain at the injection site, headache, high or low blood sugar and gallstones with long-term use. A slow heartbeat and thyroid changes can occur.

Get urgent medical help if you have severe pain in the upper right tummy (possibly with fever or yellow skin), signs of very low blood sugar (sweating, shaking, confusion), a very slow or irregular heartbeat, fainting, or a severe allergic reaction.

Pregnancy and Lactation

Experience in pregnancy is limited, so it is used only if clearly needed, as advised by your doctor. It is not known whether it passes into breast milk; ask your doctor before breastfeeding.

Precautions and Warnings

Blood sugar, thyroid tests and gallbladder ultrasound may be checked during long-term treatment. Tell your doctor about diabetes, heart rhythm problems, liver or kidney disease or gallbladder problems. Rotate injection sites. It may lower vitamin B12 levels with long use.

Overdose

Overdose may cause a slow heartbeat, flushing, stomach cramps, diarrhoea, nausea and changes in blood sugar. Contact a doctor; treatment is supportive.

Therapeutic Class

Somatostatin analogue (hormone-regulating medicine).

Storage

Store in a refrigerator at 2 to 8°C, do not freeze, protect from light and keep out of the reach of children. Follow any pack instructions about short periods at room temperature.