Introduction
Sandostatin SC is used in the treatment of acromegaly, carcinoid tumors, and bleeding esophageal varices. It is also used to prevent complications following surgery of the pancreas.
Sandostatin SC is generally given by a healthcare professional. You should not self-administer this medicine at home. Your doctor will decide the dose and how often you should take them. You should use it regularly to get the most benefit from the medicine. Do not stop using the medicine even if you feel better unless the doctor tells you so.
Using this medicine may cause few common side effects such as diarrhea, abdominal pain, nausea, constipation, flatulence, and headache. Let your doctor know if any of these side effects do not go away or get worse. Before using this medicine, inform your doctor if you have problems with your liver. You should also tell your doctor all the other medicines you are taking.
Uses of Sandostatin SC
- Acromegaly
- Carcinoid tumours
- Bleeding esophageal varices
Side effects of Sandostatin SC
Common
- Diarrhea
- Abdominal pain
- Nausea
- Constipation
- Flatulence
- Headache
- Increased glucose level in blood
- Injection site reaction
How to use Sandostatin SC
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Sandostatin SC works
Sandostatin SC is a similar to somatostatin, a substance normally found in the human body which inhibits the effects of certain hormones such as growth hormone. It also lowers the bleeding from the food pipe by constricting (narrowing) the blood vessels.
What if you forget to take Sandostatin SC?
If you miss a dose of Sandostatin SC, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Acromegaly, Variceal haemorrhage, Secretory neoplasms, Following pancreatic surgery, HIV-associated diarrhoea
Administration
IV Preparation
Common diluent: 50-100 ?g/50 mL NS
Common diluent for continuous IV infusion: 1200 ?g/250 mL NS
Minimum volume: 50 mL NS
IV/IM Administration
IM
Administer suspension (depot injection) immediately after reconstitution; inject into gluteal muscle, avoiding deltoid
IV
IV administration may be IVP, IVPB, or continuous infusion
Regular injection only: IVP should be administered undiluted over 3 minutes
IVPB: Administer over 15-30 minutes
Continuous infusion: 25-50 ?g/hr for treatment of esophageal variceal bleeding
Adult Dose
Acromegaly
Solution: 50 mcg SC q8hr initially; titrate up to 500 mcg SC q8hr if necessary; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
Suspension (depot injection): 20 mg IM (gluteal) every 4 weeks for 3 months; titrate up or down to 10-30 mg IM every 4 weeks, depending on response; not to exceed 40 mg, as follows
Symptoms controlled: If GH < 1 ng/mL and IGF-1 normal, decrease dose to 10 mg IM every 4 weeks; if GH < 2.5 ng/mL and IGF-1 normal, maintain dose at 20 mg IM every 4 weeks
Symptoms uncontrolled: If GH > 2.5 ng/mL or IGF-I elevated, increase dose to 30 mg IM every 4 weeks; if symptoms persist, increase to 40 mg IM
Carcinoid Tumor
Solution: 100-600 mcg/day SC divided q6-12hr; may titrate to 1500 mcg/day; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
Suspension (depot injection): 20 mg IM every 4 weeks if regular injection well tolerated
Subcutaneous
Prophylaxis of complications following pancreatic surgery
Adult: 100 mcg tid of a rapid-acting preparation given for 7 consecutive days, starting at least 1 hr before operation.
HIV-associated diarrhoea
Adult: Initial dose 100 mcg tid. If symptoms are not controlled after 1 wk, increase dose to 500 mcg tid.
Intravenous
Variceal haemorrhage in patients with cirrhosis
Adult: As continuous IV infusion: 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding).
Hepatic impairment: Cirrhosis, 10 mg IM every 4 weeks initially, then titrate to effect
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment: Without dialysis, dose adjustment not necessary; with dialysis, 10 mg IM every 4 weeks initially, then titrate to effect
Contraindication
Hypersensitivity.
Mode of Action
Octreotide is a synthetic analogue of somatostatin which acts by suppressing basal and stimulated secretion of growth hormone (GH). It also suppresses LH response to gonadotrophin-releasing hormone and reduces the secretion of gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin and pancreatic polypeptide.
Precaution
Renal disease; risk of gall bladder disease; DM; hypothyroidism. Pregnancy, lactation, children, elderly. Monitor levels of vitamin B12 during long term therapy.
Lactation: Whether octreotide crosses into breast milk is not known; avoid giving to lactating women
Side Effect
>10%
Gallbladder problems (>60%): Decreased gallbladder contractility, gallstones, cholecystitis, cholestatic hepatitis,Dysglycemia (25%),Hypothyroidism (25%),Bradycardia (25%)
1-10%
ECG changes (10%),Arrhythmia (9%),Pancreatitis,Upper respiratory tract infection,Fatigue,Headache,Malaise,Rash,Diarrhea,Nausea,Vomiting,Pain at injection site,Joint pain,Blurred vision
Interaction
Dosage adjustment of concurrent therapy may be necessary with calcium channel blockers, oral hypoglycaemics, ?-blockers, diuretics. May increase concentration of bromocriptine.
Potentially Fatal: Requirements of insulin may be reduced requiring careful blood-glucose monitoring. Reduction in ciclosporin bioavailability and efficacy.