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Octreotide

(ock-tree-oh-tide)

Trade/other name(s): Sandostatin, Sandostatin LAR

Why would this drug be used?

Octreotide is used in cancer treatment to control some symptoms of carcinoid syndrome (such as flushing, wheezing, and diarrhea) and to treat graft-versus-host disease. It is also used to treat diarrhea caused by chemotherapy, radiation, and AIDS. It can be used for other purposes as well.

How does this drug work?

Octreotide behaves like somatostatin, a naturally occurring hormone that helps control many functions in the body. One important effect is that it slows the time the stool passes through the intestines. This allows water to be absorbed from the stool, so the stool becomes more solid. It also blocks the release of serotonin, gastrin, and pancreatic enzymes. Octreotide is usually used for diarrhea that is not due to any cause that can be corrected, and only when other diarrhea treatments have not worked.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, or foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), or heart disease. These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have diabetes. If you take insulin you may be at higher risk of low blood sugar while taking octreotide, and you may need less insulin. If you take a pill for diabetes, it may not work as well and your dose may need to be increased. With either type of diabetes, you and your doctor may need to watch your glucose levels closely while you are getting this drug.
  • If you have gallstones or gallbladder trouble. This medicine increases the risk of gallstones.
  • If you have ulcerative colitis, fever, blood or mucus in your stools, or stools that look like black tar. You may have a more serious problem.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. Although animal tests show no birth defects, testing in pregnant women has not been done.
  • If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could affect the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Cyclosporine levels may be reduced if taken along with octreotide. Your cyclosporine dose may need to be increased.

Bromocriptine levels may be higher if taken with octreotide, and your bromocriptine dose may need to be lowered.

Insulin, anti-diabetic pills (oral hypoglycemic drugs), and certain medicines for high blood pressure or congestive heart failure (such as beta blockers, calcium channel blockers, or diuretics) may need dose adjustments while you are taking octreotide.

Check with your doctor, nurse, or pharmacist about other medicines, vitamins, herbs, and supplements, and whether alcohol can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

The short-acting form of octreotide is given as a "shot" (injection) just under the skin. Octreotide can also be given as an injection in a vein 1 to 4 times a day, or as a continuous infusion for 24 hours. A long-acting form can be given in the muscle. You or a family member may be taught to give the shot. After the right dose is found, most patients can take the long-acting shot every 4 weeks.

The dose depends on the amount that works, and the number of doses depends on why you are taking the medicine. Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Ask your nurse or doctor about getting a special container for used syringes and needles. Find out when you should bring the filled needle container back to the office.

Store the medicine in its original package in the refrigerator. Take it out up to 1 hour before the shot is due. Protect from light. Keep the syringes, needles, supplies, and the container of used needles and syringes in a safe place, out of the reach of children and pets.

Precautions

Diarrhea can cause dehydration and deplete important minerals in the body. It is very important to drink plenty of liquids while you are being treated for diarrhea. Try to take in 2 to 3 quarts a day until the diarrhea is under control. Check with your doctor if you notice dizziness, lightheadedness, low urine output, dry mouth, unusual thirst, or dry, loose skin.

To help decrease diarrhea, change your diet. Try eating small, frequent meals that are warm or at room temperature. Stay away from foods that cause gas (such as broccoli or beans), fatty foods (such as bacon or cheese), citrus fruits and juices, and high-lactose foods (such as milk or ice cream). Eat foods high in sodium and potassium (such as soups, sports drinks, and bananas). Foods high in soluble fiber (such as rice or bananas) may also help. Stay away from foods high in insoluble fiber (such as cereal or nuts). To add calories and fluids without worsening diarrhea, mix fruit juice with water.

Octreotide can affect your blood sugar. Call your doctor if you notice increased thirst and urination, or if you have shakiness, sweating, weakness, or chills.

Call your doctor if you have stomach pain, swollen or bloated belly, vomiting, or constipation.

Rarely, when taken for a long time, octreotide can affect your thyroid. Let your doctor know if you notice feeling depressed, husky or hoarse voice, swelling at the front of the neck, tiredness, weakness, thinning hair, coarse dry skin, or weight gain.

If octreotide is taken over a long time, your doctor may check your vitamin B12 or your thyroid hormone levels, since the drug can cause these to drop too low.

Tell your doctor or nurse if the diarrhea does not go away after 1 to 2 doses. The dose of the drug may need to be changed.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • nausea
  • pain and bruising at place of injection
  • gallstones or gall sludge

Less common

  • abdominal pain
  • decreased absorption of fat from intestines
  • decreased appetite
  • headache

Rare

  • anxiety
  • joint or muscle aches
  • rash
  • dizziness
  • lightheadedness
  • swelling of feet
  • headache
  • facial flushing
  • changes in blood sugar levels, especially in diabetics*
  • low thyroid function*
  • goiter (non-cancerous thyroid tumor)
  • blocked bile ducts
  • allergic reaction with trouble breathing or swallowing, hives (skin welts), itching, swelling of face, tongue, or throat

*See the "Precautions" section for more detailed information.

There are some other side effects that are not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1988

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs


Last Medical Review: 10/27/2009
Last Revised: 10/27/2009