II. Physiology
- Similar to Somatostatin, an endogenous Hormone
- Octreotide is a synthetic long-acting cyclic octapeptide that mimics Somatostatin activity
- Broad hormonal release inhibition
- Inhibits Serotonin release
- Inhibits Gastrin release
- Inhibits vasoactive intestinal peptide (VIP) release
- Inhibits Insulin release
- Inhibits Glucagon release
- Inhibits Secretin release
- Inhibits motilin release
- Inhibits pancreatic peptide release
- Inhibits Growth Hormone and IGF-1 release
- Decreases Luteinizing Hormone (LH) release in response to Gonadotrophin-Releasing Hormone (GnRH)
- Decreases Thyroid Stimulating Hormone release (TSH)
- Activity
- Vasoconstriction
- Decreases portal vessel pressure
- Decreased splanchnic Blood Flow
III. Indications
- Emergency Indications
- Bleeding Esophageal Varices
- Decreases pressure in Portal Hypertension
- May decrease Upper Gastrointestinal Bleeding rate
- Sulfonylurea Toxicity
- Decreases recurrent Hypoglycemia risk
- Bleeding Esophageal Varices
- Endocrine Indications
- Diarrhea associated with endocrine tumors
- Carcinoid Tumors
- Intestinal peptide-Secreting tumors
- Has also been used in HIV related Diarrhea, Irritable Bowel Syndrome and gastrointestinal fistulas
- Endocrine conditions in children
- Congenital hyperinsulinism
- Hypothalamic Obesity
- Diarrhea associated with endocrine tumors
IV. Dosing: Emergent Conditions (off-label)
-
Esophageal Varices
- Bolus: 50 mcg IV every 1 hour for up to 2 doses
- Maintenance: 25-50 mcg/hour for 2-5 days
-
Sulfonylurea Toxicity
- Subcutaneous (preferred): 50 mcg SQ every 6 hours as needed
- IV infusion: 25-50 mcg/hour for up to 1-2 days as needed for persistent and recurrent Hypoglycemia
V. Dosing: Endocrine
-
Diarrhea associated with Carcinoid Tumors or intestinal peptide-Secreting tumors
- Sandostatin 200-300 mcg divided 2-4 times daily given SQ or IV
- Sandostatin LAR 20 mg IM every 4 weeks for 2 months
- Do not start Sandostatin LAR until stabilized on the short-acting Sandostatin
- Endocrine conditions in children
- Congenital hyperinsulinism
- Hypothalamic Obesity
VI. Adverse Effects
- Bradycardia (<25%)
- Hyperglycemia (<27%)
- Fatigue (<10%)
- Gall Bladder sludging and Biliary Colic
- QT Prolongation
VII. References
- Kraus and LoVecchio (2018) Crit Dec Emerg Med 32(9): 28
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Definition (NCI_NCI-GLOSS) | A drug similar to the naturally occurring growth hormone inhibitor somatostatin. Octreotide is used to treat diarrhea and flushing associated with certain types of tumors. |
Definition (NCI) | A synthetic long-acting cyclic octapeptide with pharmacologic properties mimicking those of the natural hormone somatostatin. Octreotide is a more potent inhibitor of growth hormone, glucagon, and insulin than somatostatin. Similar to somatostatin, this agent also suppresses the luteinizing hormone response to gonadotropin-releasing hormone, decreases splanchnic blood flow, and inhibits the release of serotonin, gastrin, vasoactive intestinal peptide (VIP), secretin, motilin, pancreatic polypeptide, and thyroid stimulating hormone. |
Definition (MSH) | A potent, long-acting synthetic SOMATOSTATIN octapeptide analog that inhibits secretion of GROWTH HORMONE and is used to treat hormone-secreting tumors; DIABETES MELLITUS; HYPOTENSION, ORTHOSTATIC; HYPERINSULINISM; hypergastrinemia; and small bowel fistula. |
Definition (CSP) | potent, long-acting synthetic somatostatin octapeptide analog. |
Concepts | Pharmacologic Substance (T121) , Hormone (T125) , Amino Acid, Peptide, or Protein (T116) |
MSH | D015282 |
SnomedCT | 109053000, 126155003 |
LNC | LP97954-9, MTHU035158 |
English | Octreotide, L-Cysteinamide, D-phenylalanyl-L-cysteinyl-L-phenylalanyl-D-tryptophyl-L-lysyl-L-threonyl-N-(2-hydroxy-1-(hydroxymethyl)propyl)-, cyclic (2-7)-disulfide, (R-(R*,R*))-, D-Phenylalanyl-L-cysteinyl-L-phenyl-alanyl-D-tryptophyl-L-lysyl-L-threonyl-N-[2-hydroxy-1-(hydroxymethyl)propyl]-L-cysteinamide Cyclic (2->7)-Disulfide, D-Phenylalanyl-L-cysteinyl-L-phenylalanyl-D-tryptophyl-L-lysyl-L-threonyl-L-cysteinyl-L-threoninol Cyclic (2->7)-Disulfide, octreotide, OCTREOTIDE, Octreotide [Chemical/Ingredient], D-Phenylalanyl-L-cysteinyl-L-phenylalanyl-D-tryptophyl-L-lysyl-L-threonyl-N-[(1R,2R)-2-hydroxy-1-(hyroxymethyl)propyl]-L-cysteinamide, Cyclic (2->7)-disulfide, Octreotide (substance), Octreotide preparation (product), Octreotide preparation, Octreotide preparation (substance) |
Swedish | Oktreotid |
Spanish | preparado de octreotida, octreótido (sustancia), octreotida, octreotida (sustancia), octreotida (producto), preparado de ocreotide, preparado con octreotida (producto), preparado con octreotida, octreótido, Octreótido, preparado de octreotida (sustancia), preparado de octreotida (producto) |
Czech | oktreotid |
Finnish | Oktreotidi |
Russian | OKTREOTID, SMS 201-995, ОКТРЕОТИД |
Japanese | オクトレオチド, 酢酸オクトレオチド, サンドスタチン, オクトレオチド酢酸塩 |
Croatian | OKTREOTID |
Polish | Oktreotyd |
Portuguese | Octreotide, Octreotida |
French | Octréotide |
German | Octreotid |
Italian | Octreotide |
Ontology: Sandostatin (C0678117)
Concepts | Pharmacologic Substance (T121) , Hormone (T125) , Amino Acid, Peptide, or Protein (T116) |
MSH | D015282 |
English | Sandostatin, sandostatin, sandostatine, SandoSTATIN, Sandostatine |
Ontology: Sandostatin LAR (C0723209)
Concepts | Pharmacologic Substance (T121) , Hormone (T125) , Amino Acid, Peptide, or Protein (T116) |
English | Sandostatin LAR, SandoSTATIN LAR, Sandostatin-LAR |