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octreotide (Injection route, Intramuscular route)

Pronunciation

ok-TREE-oh-tide

Commonly used brand name(s)

In the U.S.

  • Sandostatin
  • Sandostatin LAR Depot

Available Dosage Forms:

  • Powder for Suspension
  • Powder for Solution
  • Solution

Therapeutic Class: Endocrine-Metabolic Agent

Pharmacologic Class: Somatostatin (class)

Uses For octreotide

Octreotide injection is used to treat severe diarrhea and other symptoms that occur with certain intestinal tumors or metastatic carcinoid tumors (tumors that has already spread in the body). It does not cure the tumor but it helps the patient feel more comfortable.

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Octreotide injection is also used to treat a condition called acromegaly, which is caused by too much growth hormone in the body. Too much growth hormone produced in adults causes the hands, feet, and parts of the face to become large, thick, and bulky. Other problems such as arthritis also can develop. Octreotide works by reducing the amount of growth hormone that is produced by the body.

Octreotide may also be used for other medical conditions as determined by your doctor.

Octreotide is available only with your doctor's prescription

Before Using octreotide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For octreotide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to octreotide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of the short-acting form of octreotide injection in the pediatric population. Safety and efficacy have not been demonstrated.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of the long-acting form of octreotide injection in children 6 to 17 years of age.

Geriatric

Although appropriate studies on the relationship of age to the effects of octreotide have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of octreotide injection in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving octreotide injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving octreotide, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using octreotide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Bepridil
  • Cisapride
  • Dronedarone
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using octreotide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acetophenazine
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Aprindine
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azimilide
  • Azithromycin
  • Bretylium
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Dasatinib
  • Desipramine
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Droperidol
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Ethopropazine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluphenazine
  • Foscarnet
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Levofloxacin
  • Lidoflazine
  • Lopinavir
  • Lorcainide
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Methotrimeprazine
  • Mifepristone
  • Moxifloxacin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Perphenazine
  • Pipotiazine
  • Pirmenol
  • Posaconazole
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propiomazine
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Risperidone
  • Salmeterol
  • Saquinavir
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Sunitinib
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Thiethylperazine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Triflupromazine
  • Trimeprazine
  • Trimethoprim
  • Trimipramine
  • Vandetanib
  • Vardenafil
  • Vasopressin
  • Vemurafenib
  • Vinflunine
  • Voriconazole
  • Zolmitriptan
  • Zotepine

Using octreotide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Pegvisomant

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of octreotide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Cholangitis (inflammation or swelling of the bile duct) or
  • Congestive heart failure or
  • Gallbladder disease or
  • Gallstones, or history of or
  • Heart rhythm problems (e.g., arrhythmia, QT prolongation, slow heartbeat) or
  • Pancreatitis (inflammation or swelling of the pancreas) or
  • Thyroid problems or
  • Vitamin B12 deficiency—Use with caution. May make these conditions worse.
  • Diabetes—Octreotide may cause high or low blood sugar. Your doctor may need to change the dose of your insulin or diabetes medicine.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of octreotide

octreotide is given as a shot under your skin, into a muscle or vein.

A nurse or other trained health professional may give you octreotide or octreotide may be given at home to patients who do not need to be in the hospital or clinic. If you are using octreotide at home, your doctor or nurse will teach you how to prepare and inject the medicine. Be sure that you understand how to use the medicine.

You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.

You might not use all of the medicine in each ampul or vial (glass container). Do not save an opened ampul or vial. If the medicine in the ampul or vial has changed color, or if you see particles in it, do not use it.

Some patients may feel pain, stinging, tingling, or burning sensations at the place where they inject the medicine. Injecting the medicine after it has been warmed to room temperature rather than cold from the refrigerator may reduce the discomfort. However, do not use heat to warm it faster because heat can destroy the medicine.

Put used needles and syringes in a puncture-resistant disposable container or dispose of them as directed by your doctor. Do not reuse needles and syringes.

Dosing

The dose of octreotide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of octreotide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For long-acting injection dosage form:
    • For treatment of acromegaly:
      • Adults—At first, 20 milligrams (mg) injected into the gluteal muscle once every 4 weeks for 3 months. Your doctor will adjust your as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of severe diarrhea and other symptoms that occur with certain types of intestinal tumors:
      • Adults and teenagers—At first, 20 milligrams (mg) injected into the gluteal muscle once every 4 weeks for 2 months. Your doctor will adjust your as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
  • For short-acting injection dosage form:
    • For treatment of acromegaly:
      • Adults—At first, 50 micrograms (mcg) injected under the skin or into a vein three times a day. Your doctor will adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of carcinoid tumors:
      • Adults—At first, 100 to 600 micrograms (mcg) per day, divided into two or four doses and injected under the skin for the first 2 weeks. Your doctor will adjust your dose as needed. However, the dose is usually not more than 1500 mcg per day.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of severe diarrhea that occurs with certain types of intestinal tumors:
      • Adults—At first, 200 to 300 micrograms (mcg) per day, divided into two or four doses and injected under the skin for the first 2 weeks. Your doctor will adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of octreotide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of the long-acting form of octreotide, contact your doctor.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

Ampules of the short-acting form of octreotide injection may be kept at room temperature for 14 days when they are protected from light. If the ampuls are not protected from light, problems with the solution can develop much sooner.

Precautions While Using octreotide

It is very important that your doctor check you closely while you are receiving octreotide. This is to make sure that octreotide is working properly. Blood tests may be needed to check your progress

Make sure your doctor knows if you are pregnant or planning to become pregnant. You must use an effective form of birth control to keep from getting pregnant. Talk to your doctor about effective birth control.

octreotide may increase your risk of developing gallstones. Call your doctor right away if you have severe stomach pain with nausea and vomiting after receiving octreotide.

octreotide may cause hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). You should check your blood sugar more often while taking octreotide and then on a regular basis.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

octreotide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Abdominal or stomach pain
  • blurred vision
  • constipation
  • depressed mood
  • dizziness
  • dry mouth
  • dry skin and hair
  • fainting
  • fast, slow, or irregular heartbeat
  • feeling cold
  • flushed, dry skin
  • fruit-like breath odor
  • hair loss
  • hoarseness or husky voice
  • increased hunger
  • increased thirst
  • increased urination
  • muscle cramps and stiffness
  • nausea
  • severe stomach pain with nausea and vomiting
  • sweating
  • troubled breathing
  • unexplained weight loss
  • unusual tiredness or weakness
  • vomiting
  • weight gain
Less common or rare
  • Abdominal or stomach bloating
  • anxious feeling
  • behavior change similar to drunkenness
  • changes in menstrual periods
  • cold sweats
  • confusion
  • convulsions (seizures)
  • cool, pale skin
  • decreased sexual ability in males
  • difficulty with concentrating
  • drowsiness
  • headache
  • loss of appetite
  • muscle cramps and stiffness
  • nightmares
  • restless sleep
  • shakiness
  • slurred speech
  • swelling of the front part of the neck
  • tiredness
  • troubled breathing (rapid and deep)
  • unconsciousness
  • unusual thirst
Incidence not known
  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chills
  • darkened urine
  • fever
  • indigestion
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pinpoint red spots on the skin
  • severe constipation
  • unusual bleeding or bruising
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Abdominal or stomach discomfort
  • decreased appetite
  • diarrhea
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast, shallow breathing
  • feeling of warmth
  • general feeling of discomfort
  • light-colored stools
  • muscle pain or cramping
  • no blood pressure or pulse
  • redness of the face, neck, arms, and occasionally, upper chest
  • shortness of breath
  • sleepiness
  • stopping of heart
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • upper right abdominal or stomach pain
  • weakness
  • weight loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Pain, redness, stinging, swelling, tingling, or burning sensation at the injection site
  • passing of gas
Less common or rare
  • Backache
  • bladder pain
  • cloudy urine
  • cough
  • difficult, burning, or painful urination
  • disturbed color perception
  • double vision
  • frequent urge to urinate
  • frequent urination usually with very small amounts of urine
  • general feeling of discomfort or illness
  • halos around lights
  • itching skin
  • joint pain
  • lack of appetite
  • loss of vision
  • lower back or side pain
  • muscle aches and pains
  • night blindness
  • overbright appearance of lights
  • runny nose
  • shivering
  • sore throat
  • stools that float, are foul smelling, and fatty in appearance
  • trouble concentrating
  • trouble sleeping
  • tunnel vision

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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