Generic
Octreotide
3 brands available in the market
At a glance
Octreotide is a synthetic somatostatin analogue used for acromegaly, carcinoid tumors, VIPomas and variceal bleeding. It inhibits growth hormone and other hormone secretion and reduces bleeding by vasoconstriction.
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, reduces splanchnic blood flow, and inhibits secretion of serotonin, gastrin, VIP, secretin, motilin and pancreatic polypeptide.
Indications
- Acromegaly (inadequate response to surgery/radiation or unable to tolerate bromocriptine)
- Carcinoid tumors (severe diarrhea and flushing)
- VIPomas (VIP-secreting tumors)
- Esophageal variceal hemorrhage in cirrhosis
- Prophylaxis of complications following pancreatic surgery
- HIV-associated diarrhea
Therapeutic class
Growth Hormone Antagonist
Pharmacological class
Somatostatin Analogue
Pharmacology
Octreotide acts like somatostatin to inhibit growth hormone (GH), glucagon and insulin secretion. It suppresses LH response, reduces splanchnic blood flow, and inhibits various hormone secretions to control carcinoid symptoms and VIPoma diarrhea.
Mechanism of action
Treats acromegaly and hormone-producing tumors by inhibiting growth hormone and other hormone secretion.
Dosage
Acromegaly (SC): 50 mcg 3 times daily (initial); titrate up to 500 mcg 3 times daily
Acromegaly (Depot IM): 20 mg every 4 weeks for 3 months; 10-30 mg every 4 weeks
Carcinoid Tumor (SC): 100-600 mcg/day in 2-4 divided doses; up to 1500 mcg/day
Carcinoid Tumor (Depot IM): 20 mg every 4 weeks
VIPomas: 200-300 mcg/day in 2-4 divided doses
Variceal Bleeding (IV): 25 mcg/hour for 48 hours (up to 5 days in high risk)
Pancreatic Surgery Prophylaxis: 100 mcg 3 times daily for 7 days
Administration
- SC: Inject into abdominal wall (rotate sites daily)
- Depot IM: Inject into gluteal muscle
- IV: Continuous IV infusion by doctor or nurse
Missed dose
Not generally applicable (scheduled administration); consult doctor if needed.
Side effects
Common Side Effects (>10%):
- Gallbladder abnormalities
- Sinus bradycardia
- Diarrhea
- Loose stools
- Nausea
- Abdominal discomfort
- Hyperglycemia
- Hypothyroidism
Precautions & warnings
- Monitor gallbladder for stone formation
- Monitor glucose levels (hypo/hyperglycemia)
- Monitor thyroid function
- Monitor cardiac function (bradycardia, arrhythmias)
- Monitor vitamin B12 levels
Contraindications
- Hypersensitivity
Drug interactions
- Decreased cyclosporine blood levels (transplant rejection)
- Dose adjustment needed for insulin and oral hypoglycemics
- Increased availability of bromocriptine
- Additive effect with bradycardia-inducing drugs
- Caution with CYP3A4-metabolized drugs (quinidine, terfenadine)
- At least 24 hours interval with Lutetium Lu 177 dotatate
Food interactions
Safety with alcohol not known; consult doctor.
Use in pregnancy
Use in Pregnancy: Octreotide is safe during pregnancy (Category B); animal studies show low or no adverse effects.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Octreotide is probably safe during breastfeeding; no significant risk to baby.
Pediatric use
Safety and efficacy not established in pediatric patients.
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: Without dialysis, no dose adjustment needed; with dialysis, 10 mg IM every 4 weeks initially.
Hepatic Impairment: Cirrhosis: 10 mg IM every 4 weeks initially, then titrate to effect.
Overdose effects
Overdose: Hypoglycemia, nausea, abdominal pain; symptomatic treatment.
Storage conditions
Store at 2-8°C; stable at room temperature for up to 14 days.
Chemical structure
Octreotide