Sandostatin Disease Interactions

Octreotide is eliminated by the kidney. Approximately 30% of octreotide is excreted unchanged in the urine. The serum concentration of octreotide and the half-life is increased in patients with severe renal dysfunction. Therapy with octreotide should be administered cautiously and dosage modification considered in patients with severe renal impairment as the half-life of octreotide may be increased, necessitating adjustment of the dosage.

Octreotide inhibits gallbladder contractility and may alter bile composition. An average of 29% of patients develop new gallstones during octreotide therapy, and up to 20% of patients develop biliary sludge. Associated pancreatitis has been reported in rare cases. Gallbladder hypercontractility, sometimes resulting in biliary colic, has been reported upon withdrawal of octreotide.

The incidence of hypoglycemia may increase during octreotide therapy due to inhibition of glucagon and growth hormone. Hyper- and hypoglycemia have been associated with the use of octreotide in nondiabetic patients with acromegaly. Clinical monitoring of blood glucose is recommended in patients with diabetes or insulinoma.

Bradycardia, arrhythmias and conduction abnormalities, including QT prolongation have been reported with the use of octreotide. Patients taking other drugs that have bradycardic effects may need dose adjustments. Caution is recommended in patients with cardiac function abnormalities.

The half-life of octreotide may be increased in patients with liver cirrhosis, necessitating adjustment of dosage. This dose should be up titrated based on clinical response and speed of response as deemed necessary by the physician.

Rarely, hypothyroidism requiring thyroid hormone replacement may occur during chronic therapy. More commonly, a statistically significant, but usually clinically insignificant, increase in TSH may be observed, possibly caused by slight inhibition of peripheral deiodination of thyroxin. Therapy with octreotide should be administered cautiously to patients with uncontrolled thyroid disorders. Clinical monitoring of thyroid function is recommended.

Decreased serum concentrations of vitamin B12 have occurred during chronic administration of octreotide. Therapy with octreotide should be administered cautiously to patients with uncontrolled vitamin B12 deficiency.