Octreotide

Octreotide Brand Names

Bynfezia | Mycapssa | Sandostatin | Sandostatin LAR

What is Octreotide

Octreotide is a synthetic analog of the naturally occurring hormone somatostatin.

The activity of octreotide is similar to that of somatostatin. Octreotide, however, has a longer half-life, greater selectivity for inhibiting glucagon, growth hormone, and insulin release, and a lower incidence of rebound hypersecretion after discontinuation.

Based on this activity, octreotide injectable products have been approved for various indications, including the treatment of acromegaly and for use in controlling the symptoms associated with vasoactive intestinal peptide tumors (VIPomas; watery diarrhea) and metastatic carcinoid tumors (flushing and diarrhea).

An oral formulation is approved for acromegaly treatment in adults previously responding to octreotide or lanreotide injections.

Non-FDA-approved uses of octreotide include AIDS-associated diarrhea, esophageal varices, pituitary tumors (i.e., thyrotropinomas), and hepatorenal syndrome.

Preliminary data also indicate that octreotide may be useful in suppressing excessive insulin secretion in pediatric patients with hypothalamic obesity from a cranial insult due to a tumor, surgery, or after cranial irradiation.

The suppression of insulin secretion by octreotide leads to decreases in weight and BMI while improving quality of life.

Indications

1. acromegaly
2. AIDS-associated enteropathy
3. carcinoid
4. chemotherapy-induced diarrhea
5. chylothorax
6. cluster headache
7. congenital hyperinsulinemia
8. diarrhea
9. dumping syndrome
10. enterocutaneous fistula
11. hepatorenal syndrome
12. hyperthyroidism
13. hypothalamic obesity
14. ileostomy-associated diarrhea
15. insulinoma
16. neurogenic orthostatic hypotension
17. pancreatic fistula
18. secondary hypoglycemia
19. short bowel syndrome
20. sulfonylurea overdose
21. thyrotropinoma
22. upper GI bleeding
23. variceal bleeding
24. VIPoma

Side Effects

1. abdominal pain
2. alopecia
3. amenorrhea
4. amnesia
5. anaphylactoid reactions
6. anemia
7. angioedema
8. antibody formation
9. anxiety
10. aphasia
11. arthralgia
12. arthropathy
13. ascites
14. asthenia
15. back pain
16. biliary obstruction
17. blurred vision
18. bradycardia
19. cardiac arrest
20. chest pain (unspecified)
21. cholangitis
22. cholecystitis
23. cholelithiasis
24. constipation
25. cranial nerve palsies
26. depression
27. diabetes insipidus
28. diarrhea
29. dizziness
30. drowsiness
31. dyspepsia
32. dyspnea
33. edema
34. elevated hepatic enzymes
35. enterocolitis
36. epistaxis
37. fatigue
38. flatulence
39. flushing
40. galactorrhea
41. GI bleeding
42. GI obstruction
43. goiter
44. growth inhibition
45. gynecomastia
46. headache
47. hearing loss
48. heart failure
49. hematoma
50. hematuria
51. hemorrhoids
52. hepatitis
53. hyperglycemia
54. hyperhidrosis
55. hypertension
56. hyperthermia
57. hypoglycemia
58. hypothyroidism
59. ileus
60. increased urinary frequency
61. infection
62. influenza
63. injection site reaction
64. intracranial bleeding
65. jaundice
66. menstrual irregularity
67. migraine
68. musculoskeletal pain
69. myalgia
70. myocardial infarction
71. nausea
72. nephrolithiasis
73. neuritis
74. ocular hypertension
75. oligomenorrhea
76. orthostatic hypotension
77. palpitations
78. pancreatitis
79. pancytopenia
80. paranoia
81. paresis
82. peptic ulcer
83. petechiae
84. pharyngitis
85. phlebitis
86. pituitary apoplexy
87. pleural effusion
88. pneumothorax
89. pruritus
90. pulmonary embolism
91. pulmonary hypertension
92. QT prolongation
93. rash
94. renal failure (unspecified)
95. retinal thrombosis
96. scotomata
97. seizures
98. sinus tachycardia
99. sinusitis
100. ST-T wave changes
101. steatorrhea
102. steatosis
103. stool discoloration
104. suicidal ideation
105. syncope
106. tenesmus
107. thrombocytopenia
108. thrombosis
109. tremor
110. urticaria
111. vaginitis
112. vertigo
113. visual impairment
114. vitamin B12 deficiency
115. vomiting
116. weakness
117. weight loss

Monitoring Parameters

• blood glucose
• blood pressure
• growth rate
• heart rate
• plasma serotonin levels
• plasma substance P
• plasma vasoactive intestinal peptide (VIP) levels
• serum growth hormone concentrations
• serum IGF-1 concentrations
• thyroid function tests (TFTs)
• urinary 5-hydroxyindoleacetic acid (5-HIAA)
• weight

Contraindications

• apheresis
• AV block
• biliary obstruction
• biliary tract disease
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cardiomyopathy
• celiac disease
• cholangitis
• cholelithiasis
• contraception requirements
• diabetes mellitus
• dialysis
• electrolyte imbalance
• fat malabsorption
• females
• fever
• gallbladder disease
• gastroparesis
• geriatric
• goiter
• growth inhibition
• heart failure
• hepatic disease
• human immunodeficiency virus (HIV) infection
• hyperglycemia
• hyperparathyroidism
• hypocalcemia
• hypoglycemia
• hypokalemia
• hypomagnesemia
• hypothermia
• hypothyroidism
• infants
• long QT syndrome
• myocardial infarction
• necrotizing enterocolitis
• neonates
• pancreatitis
• pheochromocytoma
• pregnancy
• premature neonates
• QT prolongation
• renal failure
• rheumatoid arthritis
• sickle cell disease
• sleep deprivation
• stroke
• systemic lupus erythematosus (SLE)
• vitamin B12 deficiency

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