octreotide (Sandostatin, Sandostatin LAR)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the dosage for octreotide-injection?

  • Although injection into fatty tissue (subcutaneously) is preferred, octreotide acetate also can be given by injection into the vein (intravenously). Hands should be washed before and after administration.
  • Before injecting, octreotide should be allowed to come to room temperature.
  • To decrease pain associated with subcutaneous injection the smallest possible volume to deliver the drug should be used.
  • Injection sites should be rotated to decrease injection site reactions.
  • If the solution becomes cloudy, has particles, or is leaking, it should not be used. Used needles should be thrown away in a needle or sharps container.

Acromegaly treatment

  • Treatment may be started with 50 mcg three times daily. For most patients, 100 mcg three times daily was found to be effective. However, some patients required up to 500 mcg three times daily.

Carcinoid tumor treatment

  • To treat symptoms of severe diarrhea and flushing in patients with metastatic carcinoid tumors, the recommended daily dose of octreotide acetate during the first 2 weeks of treatment ranges from 100-600 mcg/day in 2-4 divided doses (average daily dose is 300 mcg).

Vasoactive intestinal peptide tumor (VIPomas) treatment

  • To treat severe diarrhea associated with VIP-secreting tumors, the recommended daily dose of octreotide acetate during the first 2 weeks of therapy is 200-300 mcg in 2-4 divided doses (150-700 mcg) to achieve symptom control. Dose may be adjusted based on individual patient response but usually doses > 450 mcg/day are not required.

The safety and effectiveness of octreotide acetate has not been demonstrated in pediatric patients. No formal studies have been performed to evaluate the safety and effectiveness of octreotide acetate in patients under the age of 6. Serious side effects including hypoxia, necrotizing enterocolitis, and death have been reported with its use in children, especially those under the age of 2.

Which drugs or supplements interact with octreotide-injection?

: Octreotide acetate can alter nutrient absorption and may interfere with the absorption of some orally taken medications.

Use of octreotide acetate with cyclosporine (Gengraf) may decrease blood levels of cyclosporine and result in transplant rejection.

If taken with octreotide acetate, dose adjustments may be required for some medications including insulin, oral anti-diabetes medicines, beta blockers, calcium channel blockers (CCBs), and agents used to control fluid and electrolyte balance.

Octreotide may decrease the removal of certain drugs broken down by the CYP3A4 liver enzymes. Therefore, octreotide should be used cautiously with other drugs that are extensively metabolized by these enzymes or those that have a low therapeutic index.

Co-administration of octreotide and bromocriptine may increase the blood levels of bromocriptine (Cycloset).

Quick GuideDigestive Disorders: Common Misconceptions

Digestive Disorders: Common Misconceptions
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