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Octreotide (Injection route, intramuscular route)

Pronunciation:

ok-TREE-oh-tide

Brand Names:

  • SandoSTATIN
  • SandoSTATIN LAR Depot

Dosage Forms:

  • Powder for Suspension
  • Powder for Solution
  • Solution

Classifications:

Therapeutic—

Endocrine-Metabolic Agent

Pharmacologic—

Somatostatin (class)

Uses of This Medicine:

Octreotide injection is used to treat severe diarrhea and other symptoms that occur with certain intestinal tumors or metastatic carcinoid tumors (tumors that has already spread in the body). It does not cure the tumor but it helps the patient feel more comfortable.

Octreotide injection is also used to treat a condition called acromegaly, which is caused by too much growth hormone in the body. Too much growth hormone produced in adults causes the hands, feet, and parts of the face to become large, thick, and bulky. Other problems such as arthritis also can develop. Octreotide works by reducing the amount of growth hormone that is produced by the body.

Octreotide may also be used for other medical conditions as determined by your doctor.

Octreotide is available only with your doctor's prescription

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of the short-acting form of octreotide injection in the pediatric population. Safety and efficacy have not been demonstrated.

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of the long-acting form of octreotide injection in children 6 to 17 years of age.

Older adults—

Although appropriate studies on the relationship of age to the effects of octreotide have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of octreotide injection in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving octreotide injection.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Bepridil
  • Cisapride
  • Dronedarone
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acetophenazine
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Aprindine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azimilide
  • Azithromycin
  • Bretylium
  • Buserelin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Cyclosporine
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Droperidol
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Ethopropazine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluphenazine
  • Foscarnet
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroquinidine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lidoflazine
  • Lopinavir
  • Lorcainide
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Methotrimeprazine
  • Metronidazole
  • Mifepristone
  • Moxifloxacin
  • Nafarelin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Ofloxacin
  • Ondansetron
  • Paliperidone
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Perphenazine
  • Pipotiazine
  • Pirmenol
  • Posaconazole
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propiomazine
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Risperidone
  • Salmeterol
  • Saquinavir
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Sunitinib
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Thiethylperazine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Triflupromazine
  • Trimeprazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vasopressin
  • Vemurafenib
  • Vinflunine
  • Voriconazole
  • Zolmitriptan
  • Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Pegvisomant

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Cholangitis (inflammation or swelling of the bile duct) or
  • Congestive heart failure or
  • Gallbladder disease or
  • Gallstones, or history of or
  • Heart rhythm problems (e.g., arrhythmia, QT prolongation, slow heartbeat) or
  • Pancreatitis (inflammation or swelling of the pancreas) or
  • Thyroid problems or
  • Vitamin B12 deficiency—Use with caution. May make these conditions worse.
  • Diabetes—Octreotide may cause high or low blood sugar. Your doctor may need to change the dose of your insulin or diabetes medicine.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of This Medicine:

This medicine is given as a shot under your skin, into a muscle or vein.

A nurse or other trained health professional may give you this medicine or this medicine may be given at home to patients who do not need to be in the hospital or clinic. If you are using this medicine at home, your doctor or nurse will teach you how to prepare and inject the medicine. Be sure that you understand how to use the medicine.

You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.

You might not use all of the medicine in each ampul or vial (glass container). Do not save an opened ampul or vial. If the medicine in the ampul or vial has changed color, or if you see particles in it, do not use it.

Some patients may feel pain, stinging, tingling, or burning sensations at the place where they inject the medicine. Injecting the medicine after it has been warmed to room temperature rather than cold from the refrigerator may reduce the discomfort. However, do not use heat to warm it faster because heat can destroy the medicine.

Put used needles and syringes in a puncture-resistant disposable container or dispose of them as directed by your doctor. Do not reuse needles and syringes.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For long-acting injection dosage form:
    • For treatment of acromegaly:
      • Adults—At first, 20 milligrams (mg) injected into the gluteal muscle once every 4 weeks for 3 months. Your doctor will adjust your as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of severe diarrhea and other symptoms that occur with certain types of intestinal tumors:
      • Adults and teenagers—At first, 20 milligrams (mg) injected into the gluteal muscle once every 4 weeks for 2 months. Your doctor will adjust your as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.
  • For short-acting injection dosage form:
    • For treatment of acromegaly:
      • Adults—At first, 50 micrograms (mcg) injected under the skin or into a vein three times a day. Your doctor will adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of carcinoid tumors:
      • Adults—At first, 100 to 600 micrograms (mcg) per day, divided into two or four doses and injected under the skin for the first 2 weeks. Your doctor will adjust your dose as needed. However, the dose is usually not more than 1500 mcg per day.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of severe diarrhea that occurs with certain types of intestinal tumors:
      • Adults—At first, 200 to 300 micrograms (mcg) per day, divided into two or four doses and injected under the skin for the first 2 weeks. Your doctor will adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, 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 dosing schedule. Do not double doses.

If you miss a dose of the long-acting form of this medicine, contact your doctor.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store in the refrigerator. Do not freeze.

Ampules of the short-acting form of octreotide injection may be kept at room temperature for 14 days when they are protected from light. If the ampuls are not protected from light, problems with the solution can develop much sooner.

Precautions While Using This Medicine:

It is very important that your doctor check you closely while you are receiving this medicine. This is to make sure that this medicine is working properly. Blood tests may be needed to check your progress

Make sure your doctor knows if you are pregnant or planning to become pregnant. You must use an effective form of birth control to keep from getting pregnant. Talk to your doctor about effective birth control.

This medicine may increase your risk of developing gallstones. Call your doctor right away if you have severe stomach pain with nausea and vomiting after receiving this medicine.

This medicine may cause hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). You should check your blood sugar more often while taking this medicine and then on a regular basis.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Abdominal or stomach pain
blurred vision
constipation
depressed mood
dizziness
dry mouth
dry skin and hair
fainting
fast, slow, or irregular heartbeat
feeling cold
flushed, dry skin
fruit-like breath odor
hair loss
hoarseness or husky voice
increased hunger
increased thirst
increased urination
muscle cramps and stiffness
nausea
severe stomach pain with nausea and vomiting
sweating
troubled breathing
unexplained weight loss
unusual tiredness or weakness
vomiting
weight gain
Less common or rare
Abdominal or stomach bloating
anxious feeling
behavior change similar to drunkenness
changes in menstrual periods
cold sweats
confusion
convulsions (seizures)
cool, pale skin
decreased sexual ability in males
difficulty with concentrating
drowsiness
headache
loss of appetite
muscle cramps and stiffness
nightmares
restless sleep
shakiness
slurred speech
swelling of the front part of the neck
tiredness
troubled breathing (rapid and deep)
unconsciousness
unusual thirst
Incidence not known
Black, tarry stools
bleeding gums
blood in the urine or stools
chills
darkened urine
fever
indigestion
pains in the stomach, side, or abdomen, possibly radiating to the back
pinpoint red spots on the skin
severe constipation
unusual bleeding or bruising
yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Abdominal or stomach discomfort
decreased appetite
diarrhea
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, shallow breathing
feeling of warmth
general feeling of discomfort
light-colored stools
muscle pain or cramping
no blood pressure or pulse
redness of the face, neck, arms, and occasionally, upper chest
shortness of breath
sleepiness
stopping of heart
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
upper right abdominal or stomach pain
weakness
weight loss

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Pain, redness, stinging, swelling, tingling, or burning sensation at the injection site
passing of gas
Less common or rare
Backache
bladder pain
cloudy urine
cough
difficult, burning, or painful urination
disturbed color perception
double vision
frequent urge to urinate
frequent urination usually with very small amounts of urine
general feeling of discomfort or illness
halos around lights
itching skin
joint pain
lack of appetite
loss of vision
lower back or side pain
muscle aches and pains
night blindness
overbright appearance of lights
runny nose
shivering
sore throat
stools that float, are foul smelling, and fatty in appearance
trouble concentrating
trouble sleeping
tunnel vision

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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