Octreotide

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Generic Name: Octreotide Brand Name(s): Generics only. No brands available.

Uses

What is Octreotide used for?

Octreotide is used to treat severe watery diarrhea and sudden reddening of the face and neck caused by certain types of tumors (e.g., carcinoid tumors, vasoactive intestinal peptide tumors) that are found usually in the intestines and pancreas. The symptoms occur when these tumors make too much of certain natural substances (hormones). This medication works by blocking the production of these hormones. By decreasing watery diarrhea, octreotide helps to reduce the loss of body fluids and minerals.

Octreotide is also used to treat a certain condition (acromegaly) that occurs when the body makes too much of a certain natural substance called growth hormone. Treating acromegaly helps reduce the risk of serious problems such as diabetes and heart disease. Octreotide works by decreasing the amount of growth hormone to normal levels.

This drug is not a cure for these conditions. This medication is usually used with other treatment (e.g., surgery, radiation, other drugs).

How should I take Octreotide?

This medication is usually given by injection under the skin, usually 2 to 3 times a day or as directed by your doctor. Depending on your condition, it may be given by injection into a vein by a health care professional.

If your doctor directs you to inject this medication under the skin yourself, learn all preparation and usage instructions from your health care professional. Learn how to store and discard needles and medical supplies safely. If you have questions, ask your health care professional.

Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. Change the location of the injection site each time to avoid problem areas under the skin.

Dosage is based on your medical condition and response to treatment.

Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Octreotide?

Store unopened vials in a refrigerator or at room temperature. If stored at room temperature, throw away after 2 weeks. To prevent drug damage, you should not store Octreotide in the bathroom or the freezer. There may be different brands of Octreotide that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Octreotide down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Single-use vial: Throw away any part left over after the dose is given.

Multi-dose container: Throw away any part not used 2 weeks after first use.

Precautions & warnings

What should I know before using Octreotide?

Before using octreotide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease (e.g., cirrhosis), diabetes, thyroid problems, gallbladder problems (e.g., gallstones), nutrition problems (e.g., decreased fat absorption, vitamin B12 deficiency).

This drug may make you dizzy. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Caution is advised when using this drug in children. Use of this medication for long periods (e.g., longer than 1 year) may slow a child’s growth rate. However, the growth rate catches up after treatment with the drug is stopped. Consult your doctor for more information.

This medication may restore the normal ability to become pregnant in females with acromegaly who have infertility. Females of childbearing age should discuss reliable forms of birth control with the doctor. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Octreotide during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Octreotide. Octreotide is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Octreotide?

Nausea, vomiting, loose/oily stools, constipation, stomach upset, gas, bloating, dizziness, or headache may occur. Pain and irritation at the injection site may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: signs of gallbladder/liver problems (e.g., fever, stomach/abdominal pain, severe nausea/vomiting, yellowing eyes/skin, unexplained pain in the back/right shoulder), signs of underactive thyroid (e.g., unexplained weight gain, cold intolerance, slow heartbeat, severe constipation, unusual/extreme tiredness, growth/lump/swelling on the front of the neck), worsening heart condition symptoms (e.g., trouble breathing, slow/fast/irregular heartbeat), numbness/tingling of the arms/legs.

This medication may rarely cause changes in blood sugar, especially if you have diabetes. Symptoms of high blood sugar include increased thirst and urination. Symptoms of low blood sugar include nervousness, shakiness, sweating, fast heartbeat, and hunger. Follow your doctor’s instructions to treat low blood sugar (e.g., eat a quick source of sugar such as glucose gel/tablets, table sugar, or honey, or drink fruit juice or non-diet soda). Tell your doctor right away if you experience symptoms of high or low blood sugar while taking this medication. Monitor your blood sugar levels as directed by your doctor. Your doctor may need to adjust your diabetes medications.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Octreotide?

Some products that may interact with this drug are: beta-blockers (e.g., metoprolol, propranolol), nutritional solutions given by vein (e.g., total parenteral nutrition-TPN), pegvisomant.

Octreotide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Octreotide?

Octreotide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Octreotide?

Octreotide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Octreotide.

What is the dose of Octreotide for an adult?

Usual Adult Dose for Carcinoid Tumor

Initial dose: 100 to 600 mcg per day, IV or subcutaneously, in 2 to 4 divided doses

Comments:

-The median daily dose was 450 mcg; mean daily dose was 300 mcg.

-Benefits were seen in doses from 50 mcg to 1500 mcg per day.

-Experience with doses above 750 mcg per day is limited.

Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):

Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 2 months; continue with dose of regular octreotide for at least 2 weeks (at same dose patient was on before the switch)

After 2 months:

-If symptoms are controlled, consider reducing dose to 10 mg every 4 weeks

-If symptoms are not adequately controlled, increase to 30 mg every 4 weeks

Maximum dose: 30 mg every 4 weeks

Comments:

-Failure to continue dosing of regular octreotide during a switch to the long acting formulation may exacerbate symptoms; some patients require 3 to 4 weeks of concomitant dosing.

Use: Symptomatic treatment of patients with metastatic carcinoid tumors where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease.

Usual Adult Dose for Vasoactive Intestinal Peptide Tumor

Initial dose: 200 to 300 mcg per day, IV or subcutaneously, in 2 to 4 divided doses

Maintenance dose: 150 to 750 mcg per day

-Doses above 450 mcg per day are not usually required.

Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):

Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 2 months; continue with dose of regular octreotide for at least 2 weeks (at same dose patient was on before the switch)

After 2 months:

-If symptoms are controlled, consider reducing dose to 10 mg every 4 weeks

-If symptoms are not adequately controlled, increase to 30 mg every 4 weeks

Comments:

-Adjust dose for therapeutic response.

Use: Long term treatment of the profuse watery diarrhea associated with Vasoactive Intestinal Peptide (VIP) secreting tumors.

Usual Adult Dose for Acromegaly

Initial dose: 50 mcg, IV or subcutaneously, 3 times a day

Maintenance dose: Usually 100 mcg, 3 times a day

Maximum dose: 500 mcg, 3 times a day

Comments:

-Starting at a low dose may help patients adapt to gastrointestinal adverse events.

-Use IGF-1 (somatomedin C) levels, every 2 weeks, to guide titration.

-Multiple growth hormone levels, zero to 8 hours after dosing, may permit more rapid dose titration.

-Doses over 300 mcg per day seldom provide additional biochemical benefit.

Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):

Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 3 months

After 3 months:

-If GH is 1 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: 10 mg, IM, every 4 weeks

-If GH is 2.5 ng/mL or less and clinical symptoms controlled: 20 mg, IM, every 4 weeks

-If GH is higher than 2.5 ng/mL and/or clinical symptoms uncontrolled: 30 mg, IM, every 4 weeks

-If GH, IGF-1, or symptoms are not adequately controlled at 30 mg, may increase dose to 40 mg IM every 4 weeks

Maximum dose: 40 mg, every 4 weeks

Comments:

-The goal is growth hormone (GH) levels under 5 ng/mL, or IGF-1 levels under 1.9 U/mL (male) or 2.2 U/mL (female).

-If increased doses do not provide additional benefit, reduce dose.

-Check IGF-1 or growth hormone levels every 6 months.

-For patients who have received irradiation: withdraw medication yearly for about 4 weeks (8 weeks for long-acting formulation) to assess disease activity; if growth hormone or IGF-1 increase and symptoms recur, resume therapy.

Use: To reduce blood levels of growth hormone and IGF-1 (somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection or radiotherapy.

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution is recommended.

Long acting formulation: For cirrhotic patients, starting dose is 10 mg every 4 weeks; titrate up based on clinical response.

Dose Adjustments

Long-acting depot formulation:

Carcinoid tumor and Vasoactive Intestinal Peptide Tumor patients:

-Exacerbation of symptoms is common.

-During exacerbations, administer regular octreotide at dose they were previously receiving (before switching to long acting) for a few days.

Dialysis

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution is recommended.

Long acting depot formulation: Starting dose is 10 mg every 4 weeks

Other Comments

Administration advice:

-Standard formulation may be given IV or subcutaneously.

-Subcutaneous route is usually used for control of symptoms.

-To minimize pain with subcutaneous administration, use smallest volume that will deliver the dose.

-Avoid multiple subcutaneous injections at the same site within a short period of time.

-Rotate sites systematically.

-Infuse IV over 15 to 30 minutes

-Administer IV push over 3 minutes

-Rapid bolus may be given for emergency situations

Storage requirements:

-Refrigerate; protect from light

-Stable for 14 days at room temperature (70 to 86F) if protected from light

Reconstitution/preparation techniques:

-Dilute in 50 to 200 mL for IV infusion

IV compatibility:

-Stable in sterile isotonic saline solutions or dextrose 5% in water (D5W) for 24 hours.

-NOT compatible with TPN (total parenteral nutrition).

Monitoring:

-Monitor IGF-1 (somatomedin C) or growth hormone levels every 6 months.

What is the dose of Octreotide for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Octreotide available?

Octreotide is available in the following dosage forms and strengths:

  • Injectable solution,
  • Intramuscular powder for injection, extended release.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a 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 take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: April 5, 2018 | Last Modified: April 5, 2018

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