| OCTREOTIDE ACETATE
Sandostatin, Sandostatin LAR depot
Classifications: hormone; somatostatin analog; Therapeutic: hormone suppressant; acromegaly agent; antidiarrheal
Pregnancy Category: B
0.05 mg/mL, 0.1 mg/mL, 0.2 mg/mL, 0.5 mg/mL, 1 mg/mL injection; 10 mg/5 mL, 20 mg/5 mL, 30 mg/5 mL depot injection
A long-acting peptide that mimics the natural hormone somatostatin. Suppresses secretion of serotonin, pancreatic peptides,
gastrin, vasoactive intestinal peptide, insulin, glucagon, secretin, and motilin.
Stimulates fluid and electrolyte absorption from the GI tract, prolongs intestinal transit time, and also inhibits the growth
Symptomatic treatment of severe diarrhea and flushing episodes associated with metastatic carcinoid tumors. Also watery
diarrhea associated with vasoactive intestinal peptide (VIP) tumors.
Acromegaly associated with pituitary tumors, fistula drainage, variceal bleeding.
Hypersensitivity to octreotide.
Cholelithiasis, renal impairment; dialysis; hepatic disease; cardiac disease; diabetes, hypothyroidism; pregnancy (category
Route & Dosage
Adult: SC/IV 100600 mcg/d in 24 divided doses, titrate to response IM May switch to depot injection after 2 wk at 20 mg q4wk x 3 mo
Adult: SC/IV 200300 mcg/d in 24 divided doses, titrate to response IM May switch to depot injection after 2 wk at 20 mg q4wk x 2 mo
Adult: SC 50 mcg t.i.d., titrate up to 100 mcg500 mcg t.i.d. IM May switch to depot injection after 2 wk at 20 mg q4wk x at least 3 mo, then reassess
- Note: Subcutaneous is the preferred route.
- Minimize GI side effects by giving injections between meals and at bedtime.
- Avoid multiple injections into the same site. Rotate SC sites on abdomen, hip, and thigh.
- Give deep IM into a large muscle. To reduce local irritation, allow solution to reach room temperature before injection
and administer slowly.
PREPARE: Direct: Give undiluted. Intermittent: Dilute in 50200 mL D5W.
ADMINISTER: Direct: Give a single dose over 3 min. In emergency (eg, carcinoid crisis), give rapid IV bolus over 60 sec. Intermittent: Give over 1530 min.
INCOMPATIBILITIES Solution/additive: Fat emulsion, regular insulin.
Adverse Effects (≥1%)CNS:
, dizziness. GI: Nausea, diarrhea,
abdominal pain and discomfort. Metabolic: Hypoglycemia
, hyperglycemia, increased liver transaminases, hypothyroidism (after long-term use). Body as a Whole:
Flushing, edema, injection site pain.
May decrease cyclosporine
levels; may alter other drug and nutrient absorption because of alterations in GI motility.
Rapidly from SC injection. Peak:
0.4 h. Duration:
Up to 12 h. Metabolism:
In liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Periodic blood glucose, liver function tests, and serum electrolytes.
- Monitor for hypoglycemia and hyperglycemia (see Appendix F), because octreotide may alter the balance between insulin, glucagon,
and growth hormone.
- Monitor fluid and electrolyte balance, as octreotide stimulates fluid and electrolyte absorption from GI tract.
- Monitor vitals signs, especially BP.
- Monitor bowel function, including bowel sounds and stool consistency.
- Dietary fat absorption may be altered in some clients. Monitor fecal fat and serum carotene to aid in the assessment of
possible drug-induced aggravation of fat malabsorption.
Patient & Family Education
- Learn proper technique for SC injection if self-medication is required.
- Note: Preferred sites for SC injections of octreotide are the hip, thigh, and abdomen. Multiple injections at the same SC injection
site within short periods of time are not recommended. This is to avoid irritating the area.