Sandostatin

What is it?

A sandostatin analogue available as a solution in ampoules for injection at strengths of 0.05mg, 0.1mg and 0.5mg per ml and 1mg per 5ml multi-dose vial, all containing octreotide (as acetate). Also, SANDOSTATIN LAR 10mg, 20mg and 30mg microspheres for suspension in vials with diluent, all containing octreotide as acetate.

Medical Uses

Sandostatin, short-term treatment of acromegaly (abnormal enlargement of face, hands and feet due to excess secretion of growth hormone by a pituitary gland tumour), before surgery to pituitary gland. Also, longterm treatment in patients with acromegaly in whom radiotherapy, surgery or dopamine agonists are not able to be used, or until radiotherapy can be resumed. Also, Relief of symptoms of certain tumours of the gastrointestinal tract and pancreas, and carcinoid tumours which release hormones. Also, after surgery to the pan. creas, to prevent complications. Sandostatin LAR, acromegaly in whom radiotherapy, surgery or dopamine agonists are not able to be used and who are controlled by sandostatin given subcutaneously, or until radiotherapy can be resumed. Also, Relief of symptoms of certain tumours of the gastro-intestinal tract and pancreas, and carcinoid tumours which release hormones, in patients being controlled with sandostatin given subcutaneously.

Dosage

Adults, sandostatin, acrornegaly, 0.1 to 0.2mg 3 times each day by subcutaneous injection. GEP tumours, 0.05mg once or twice each day at first, increasing to 0.2mg 3 times daily if needed, by subcutaneous injection. Carcinoid crisis, 0.05mg diluted with saline and given as intravenous bolus; consult manufacturer's literature. Surgery to pancreas, 0.1 mg by subcutaneous injection 3 Imes each day for 1 week, beginning 1 hour before operation. Sandostatin LAR, acromegaly, when control has been obtained by subcutaneous treatment, 20mg by deep intramuscular injection into gluteal muscle every month for 3 months then adjust dose according to test results and individual patient response. Tumours, same initial dose regimen as for acromegaly, Also, continuing with same dose of sandostatin given subcutaneously for 2 weeks. Evaluate after 3 months and adjust subsequent doses according to test results and individual patient response.

Special Care

Drugs to control diabetes may require adjustment. Those taking drug long-term require monitoring of thyroid function and for development of gallstones. Sudden loss of control of symptoms may occur. In treating carcinoid tumour, subcutaneous sandostatin should be stopped if no benefit after 1 week.

Avoid Use

Pregnancy, breastfeeding.

Possible Drug and Food Interactions

Cimetidine, bromocriptine, cyclosporin.

Known Side Effects

Pain, swelling and soreness at injection site, biliary colic, pain in abdomen, gallstones, gastrointestinal disturbance. In rare cases, persistent high blood sugar levels, low blond sugar levels, liver disorders, pancreatitis, hair loss. Any adverse side effects to Sandostatin LAR should be reported to the Committee on the safety of Medicines (CSM).