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How does Sandostatin work for GI bleeds?

Medically reviewed by Sally Chao, MD. Last updated on Oct 1, 2021.

Official answer

by Drugs.com

Sandostatin (octreotide acetate) may help treat certain types of bleeding in the gastrointestinal (GI) tract through various mechanisms, including its ability to:

  • Reduce blood flow in the gastrointestinal system
  • Inhibit stomach acids
  • Decrease the clumping of platelets

Sandostatin injections are typically only recommended for variceal bleeding, or bleeding from enlarged veins called varices that can develop in the esophagus or other parts of the upper GI tract. Varices in the esophagus are usually caused by cirrhosis of the liver, which can reduce blood flow to the liver and boost blood flow in the esophagus. Sandostatin may be recommended as part of the standard treatment for variceal bleeding.

For other forms of GI bleeding, such as peptic ulcer bleeding, the evidence supporting the use of Sandostatin is more uncertain.

The European Society of Gastrointestinal Endoscopy, for example, does not recommend using Sandostatin or other similar medicines to treat non-variceal upper gastrointestinal bleeding. Although Sandostatin may be recommended for use in some instances of non-variceal upper gastrointestinal bleeding, more evidence is needed to prove its efficacy.

The use of Sandostatin for gastrointestinal bleeding is off-label, as the drug is not approved by the U.S. Food and Drug Administration for this particular use. It is approved to treat acromegaly, as well as diarrhea associated with carcinoid and vasoactive intestinal peptide tumors (VIPomas).

References
  1. Juricek C, Imamura T, Nguyen A, et al. Long-Acting Octreotide Reduces the Recurrence of Gastrointestinal Bleeding in Patients With a Continuous-Flow Left Ventricular Assist Device. J Card Fail. 2018;24(4):249-254. https://doi.org/10.1016/j.cardfail.2018.01.011.
  2. The European Society of Gastrointestinal Endoscopy (ESGE). Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage. 2015. Available at: https://www.esge.com/assets/downloads/pdfs/guidelines/2015_s_0034_1393172.pdf. [Accessed September 17, 2021].
  3. Wells M, Chande N, Adams P, et al. Meta-analysis: vasoactive medications for the management of acute variceal bleeds. Aliment Pharmacol Ther. 2012;35(11):1267-1278. https://doi.org/10.1111/j.1365-2036.2012.05088.x.
  4. Tripathi D, Stanley AJ, Hayes PC, et al. U.K. guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut. 2015;64(11):1680-1704. http://dx.doi.org/10.1136/gutjnl-2015-309262.
  5. U.S. National Library of Medicine MedlinePlus. Esophageal Varices. Last reviewed October 15, 2019. Available at: https://medlineplus.gov/ency/article/000268.htm. [Accessed September 17, 2021].
  6. Vuddanda V, Jazayeri MA, Turagam MK, et al. Systemic Octreotide Therapy in Prevention of Gastrointestinal Bleeds Related to Arteriovenous Malformations and Obscure Etiology in Atrial Fibrillation. JACC Clin Electrophysiol. 2017;3(12):1390-1399. https://doi.org/10.1016/j.jacep.2017.04.022.
  7. U.S. Food and Drug Administration (FDA). Sandostatin®. 2002. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2003/19667scm044_Sandostatin_lbl.pdf. [Accessed September 17, 2021].

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