Drug Guide

Generic Name

Octreotide Acetate

Brand Names Sandostatin, Sandostatin LAR, Octreotide Acetate (Preservative Free), Octreotide Acetate Preservative Free, Mycapssa, Bynfezia Pen

Classification

Therapeutic: Hormonal therapy; Antineoplastic agent

Pharmacological: Somatostatin analog

FDA Approved Indications

Acromegaly
Carcinoid tumors (including VIPomas)
Other hormone-secreting tumors

Mechanism of Action

Octreotide mimics natural somatostatin, inhibiting the release of various hormones and peptides, thereby reducing tumor-related hormone secretion and controlling symptoms.

Dosage and Administration

Adult: Dosing varies by indication; for acromegaly, typically 50-100 mcg subcutaneously 3 times daily; for long-acting formulations, doses are individualized. Administer intramuscularly or subcutaneously as per prescribing info.

Pediatric: Dosing based on weight and condition; consult specific guidelines.

Geriatric: Adjustments may be necessary; monitor closely due to potential increased sensitivity.

Renal Impairment: Use with caution; dose adjustments may be required.

Hepatic Impairment: No specific adjustments necessary; monitor hepatic function.

Pharmacokinetics

Absorption: Variable with subcutaneous administration; long-acting formulations provide sustained release.

Distribution: Widely distributed; protein bound approximately 55%.

Metabolism: Metabolized by enzymes in the liver; extensive first-pass effect.

Excretion: Excreted mainly in urine and feces.

Half Life: Approximately 1.5 to 3 hours for short-acting; around 4 weeks for long-acting formulations.

Contraindications

Hypersensitivity to octreotide or somatostatin analogs

Precautions

Use with caution in patients with gallbladder disease, renal impairment, or cardiac conduction issues.
Potential for glucose metabolism disturbances; monitor blood glucose levels.
Assess for allergies to somatostatin analogs.

Adverse Reactions - Common

Gastrointestinal disturbances (nausea, diarrhea, abdominal pain) (Common)
Gallstones and gallbladder sludge (Common)
Injection site reactions (Common)

Adverse Reactions - Serious

Bradycardia, arrhythmias (Serious)
Hypersensitivity reactions, including anaphylaxis (Serious)
Hyperglycemia or hypoglycemia (Serious)

Drug-Drug Interactions

Cyp3A4 inhibitors or inducers may alter octreotide levels.
Beta-blockers, calcium channel blockers, or other agents affecting heart rate may have additive effects on cardiac conduction.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for symptom control, liver function, gallbladder ultrasound, blood glucose levels.

Diagnoses:

Risk for hypoglycemia/hyperglycemia
Impaired skin integrity at injection site
Risk for gallstones

Implementation: Administer as prescribed, rotate injection sites, monitor blood glucose, educate patient.

Evaluation: Assess for symptom relief, side effects, laboratory parameter stability.

Patient/Family Teaching

Instruct on proper injection techniques.
Report symptoms of gallstones, blood sugar changes, or allergic reactions.
Maintain regular follow-ups and lab monitoring.

Special Considerations

Black Box Warnings:

Potential for cholelithiasis and impaired gallbladder function.
Monitor for gallstones during treatment.

Genetic Factors: None specified.

Lab Test Interference: May affect serum calcitonin and possibly other hormones; interpret lab results accordingly.

Overdose Management

Signs/Symptoms: Severe hypoglycemia or hyperglycemia, injection site reactions, or symptoms of cardiac conduction abnormalities.

Treatment: Supportive care, monitor cardiac and glucose status, symptomatic treatment as needed.

Storage and Handling

Storage: Store vials at 2°C to 8°C (36°F to 46°F); protect from light. The powder for injection should be reconstituted and used promptly or stored as advised.

Stability: Stable under recommended storage conditions for the period specified in the prescribing information.