Octreotide
Class: growth hormone inhibitor – somatostatin analogue
Indications (NB some may be unlicensed): acromegaly, gastro-entero pancreatic endocrine tumours, post pancreatic surgery, emergency treatment to stop bleeding oesophageal varices, antisecretory in intestinal obstruction, nausea & vomiting due to inoperable malignant intestinal obstruction (specialist use; unapproved); secretory diarrhoea, high fistula output, variceal bleeds
Contraindications/cautions: diabetes; monitor thyroid & liver function
Adverse reactions: nausea, vomiting, abdominal pain, bloating, flatulence, diarrhoea; less common: injection site reaction, hepatitis, gallstones, hyper/hypoglycaemia, bradycardia, dizziness, drowsiness, headache, hypothyroidism
Metabolism/clearance: metabolised by the liver; half-life prolonged in cirrhosis
Interactions:
- decreased absorption of ciclosporin may occur with octreotide
- hypoglycaemic drugs and insulin (dose reduction may be required)
| Dosing: | |
|---|---|
| oral: | not available |
| subcut: | 200 to 600 micrograms/24 hours (max. 1 mg/24 hours) LAR – not usually used in palliative care |
| rectal: | not available |
| iv: | not available |
Syringe driver: see syringe driver compatibility chart
Mechanism of action: blocks somatostatin receptors
Peak effect: 30 minutes
Duration: 12 hours
Notes:
- long acting octreotide formulations are available. Their use in palliative care has not been fully established