octreotide acetate

octreotide acetate

Sandostatin, Sandostatin LAR

Pharmacologic class: Somatostatin analog

Therapeutic class: Antidiarrheal

Pregnancy risk category B

Action

Suppresses secretion of serotonin, serotonin metabolites, and gastrohepatic peptides, increasing fluid and electrolyte absorption from GI tract. Also suppresses growth hormone, insulin, and glucagon.

Availability

Depot injection: 10 mg, 20 mg, 30 mg

Injection: 0.05 mg/ml, 0.1 mg/ml, and 0.5 mg/ml in 1-ml ampules; 0.2 mg/ml and 1 mg/ml in 5-ml vials

Indications and dosages

Diarrhea and flushing associated with carcinoid tumors

Adults: 100 to 600 mcg (Sandostatin) subcutaneously or I.V. daily in two to four divided doses for 2 weeks. Then, depending on response, 20 mg (LAR Depot) I.M. q 4 weeks for 2 months.

Diarrhea caused by vasoactive intestinal peptide tumors (VIPomas)

Adults: 200 to 300 mcg (Sandostatin) subcutaneously or I.V. daily in two to four divided doses for 2 weeks. Then, depending on response, 20 mg (LAR Depot) I.M. q 2 weeks for 2 months.

Acromegaly

Adults: 50 to 100 mcg (Sandostatin) subcutaneously or I.V. two or three times daily. Then, depending on response, 20 mg (LAR Depot) I.M. q 4 weeks for 3 months. Then adjust based on growth hormone levels.

Dosage adjustment

• Renal impairment

Off-label uses

• Dumping syndrome (postprandial hypotension)

• GI and pancreatic fistulas

• Variceal bleeding

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:

• gallbladder disease, renal impairment, hyperglycemia or hypoglycemia, fat malabsorption

• pregnant or breastfeeding patients

• children.

Administration

• When giving subcutaneously, rotate administration site with each injection.

Don't give LAR Depot I.V.

• Mix I.M. solution and inject deep into gluteal muscle over 3 minutes. Don't use deltoid.

• For I.V. administration, dilute in 50 to 200 ml of dextrose 5% in water or normal saline solution. Infuse over 15 to 30 minutes.

• Know that octreotide suppression test and octreotide scintigraphy may be done to determine if drug will aid carcinoid tumor treatment.

• Drug may be kept at room temperature for 2 weeks. Refrigerate ampules.

Adverse reactions

CNS: dizziness, drowsiness, fatigue, headache, weakness

CV: edema, bradycardia, conduction abnormalities, arrhythmias

EENT: vision disturbances

GI: nausea, vomiting, diarrhea, abdominal pain, cholelithiasis, fat malabsorption

Skin: flushing

Metabolic: hypothyroidism, hyperglycemia, hypoglycemia

Other: injection site pain

Interactions

Drug-drug. Cyclosporine: reduced cyclosporine blood level

Insulin, oral hypoglycemics: altered requirements for these drugs

Orally administered drugs: altered absorption of these drugs

Drug-diagnostic tests. Glucose: increased or decreased level

Hepatic enzymes: slightly increased levels

Schilling's test: abnormal results

Thyroxine, vitamin B12: decreased levels

Drug-food. Fats: altered octreotide absorption

Patient monitoring

• Assess bowel sounds and stool frequency and consistency.

• Monitor vital signs and fluid intake and output. Stay alert for dehydration or edema.

• Evaluate diabetic patient for hypoglycemia or hyperglycemia.

• Know that in women with active acromegaly, normalization of growth hormone and insulin-like growth factor-1 may restore fertility.

Patient teaching

• Tell patient being treated for carcinoid tumor to keep track of number of daily stools or flushing episodes.

• Instruct patient to weigh himself daily and report significant changes.

• Advise female with childbearing potential to use adequate contraception while taking drug.

• If patient will use drug at home, teach correct methods for injection, storage, and needle disposal.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

octreotide acetate

Sandostatin Endocrinology A depot somatostatin analogue with high GH affinity, resulting in a ↓ serum GH and amelioration of Sx in most Pts with acromegaly Indications (1) Reduction of growth hormone and IGF-1–insulin growth factor in acromegaly; (2) suppression of severe diarrhea and flushing associated with malignant carcinoid syndrome; (3) treatment of profuse watery diarrhea associated with VIPoma–vasoactive intestinal peptide tumor–and diarrhea and flushing associated with certain types of tumors; used to control of chemotherapy-induced diarrhea and flushing in Pts with metastatic carcinoid tumors and VIPomas, and for treating acromegaly; now also in clinical trials as a potential treatment of severe chemotherapy-induced diarrhea in Pts with colorectal CA

octreotide acetate

(ŏk′trē-ō-tīd)
A synthetic drug that mimics the action of somatostatin and is used in treating acromegaly, carcinoid tumors, vasoactive intestinal peptide tumors, pancreatitis, and gastrointestinal bleeding.
References in periodicals archive ?
Octreotide acetate is currently only available by injection for patients suffering from acromegaly.
Octreotide acetate exerts pharmacological actions similar to the natural hormone, somatostatin.
According to the company, DP1038 is its investigational new drug octreotide acetate for intranasal administration.
Here we present our institution's experience and discuss our observations during management of this complication with the use of peripheral total parenteral nutrition (TPN) and octreotide acetate.
* Novartis' Sandostatin LAR (octreotide acetate for injectable suspension), which is for the treatment of acromegaly syndrome, a hormonal disorder, and for the severe diarrhea and flushing associated with meta-static cancers.
Small et al., "Effect of the somatostatin analog octreotide acetate on circulating insulinlike growth factor-1 and related peptides in patients with nonmetastatic castration-resistant prostate cancer: results of a phase II study, " Urologic Oncology, vol.
Octreotide acetate (OCT) is a synthetic octapeptide analogue of nature somatostatin [19], cyclized by a disulfide bond between the two Cys residues (D-Phe-c(Cys-Phe-D-Trp-LysThr-Cys)-Thr(ol)) [20].
Octreotide acetate (Sandostatin[R]), a somatostatin analogue, provides double vasoconstrictive effects by preventing release of glucagon, a fast-acting vasodilator, and concurrent vasoconstriction in the mesenteric veins within the portal system (Minano & Garcia-Tsao, 2010).
Other drugs on the list include duloxetine (Cymbalta), under investigation for reports of urinary retention; octreotide acetate depot (Sandostatin LAR), under investigation for reports of ileus; and desflurane (Suprane), under investigation for reports of cardiac arrest.
Other drugs on the list include duloxetine (Cymbalta), under investigation for reports of urinary retention; octreotide acetate depot (Sandostation LAR), under investigation for reports of ileus; and desflurane (Suprane), under investigation for report of cardiac arrest.