SANDOSTATIN SOLUTION 0.05MG/ML

Indications

• Acromegaly
• Neuroendocrine tumors
• Carcinoid syndrome
• VIPoma
• Esophageal variceal hemorrhage
• Diarrhea associated with certain conditions

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines based on indication and patient condition.

Adults: Refer to the BNF for specific dosing guidelines based on indication and patient condition.

Mechanism of action

Octreotide binds to somatostatin receptors, particularly subtype 2 and 5, leading to inhibition of growth hormone (GH) and insulin secretion. It also decreases the release of other hormones such as glucagon, serotonin, and gastrin. This results in various effects including reduced gastrointestinal motility and secretions, decreased splanchnic blood flow, and modulation of the endocrine system.

Pharmacodynamics

Octreotide exhibits prolonged effects compared to natural somatostatin due to its resistance to enzymatic degradation. The drug's action leads to reduced hormone levels in conditions like acromegaly and a decrease in symptoms associated with neuroendocrine tumors. Octreotide can lead to changes in glucose metabolism and has an impact on fluid and electrolyte balance.

Pharmacokinetics

Octreotide is administered via subcutaneous or intravenous routes. It has a bioavailability of approximately 60% when given subcutaneously, with peak plasma concentrations achieved within 30 minutes to 2 hours. The drug is extensively metabolized by the liver, with a half-life of about 1.5 to 2 hours, though the pharmacological effects can last much longer. It is excreted primarily via the kidneys, with a small amount eliminated unchanged in the urine.

Contra-indications

• Hypersensitivity to octreotide or any of the excipients
• Patients with a history of pancreatitis

Adverse effects

• Gastrointestinal disturbances (nausea, vomiting, diarrhea, abdominal pain)
• Injection site reactions (pain, redness, swelling)
• Hypoglycemia or hyperglycemia
• Bradycardia
• Cholelithiasis (gallstones)
• Pancreatitis

Interactions

• Insulin or oral hypoglycemic agents (may require dose adjustment due to altered glucose metabolism)
• Cyclosporine (may decrease absorption and effectiveness of cyclosporine)
• Certain medications that affect gastrointestinal motility (may interact with the action of octreotide)

Precautions

• Caution in patients with diabetes mellitus or a history of cardiac disease
• Monitor thyroid function in patients receiving long-term therapy
• Use with caution in patients with renal impairment

Pregnancy

There are limited data on the use of octreotide in pregnant women. It should only be used if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Octreotide may be excreted in breast milk; caution is advised when administering to nursing mothers.

Storage

Store in a refrigerator (2°C to 8°C). Protect from light. Do not freeze.

Formulations

• Injection (subcutaneous, intramuscular)
• Long-acting release formulation