Octreotide (Injection)

Overview

Patients who suffer from acromegaly, a condition caused by the overproduction of growth hormone, have found relief with the use of the injected drug known as octreotide. This prescription medication can help in reducing the amount of growth hormone that is produced and helps to alleviate the symptoms commonly associated with this malady. Patients typically report large, thick, and bulky areas of their body, mainly their face, hands, and feet, that can cause extreme discomfort. This disorder can also spur the development of arthritis in some patients.

This medication is also used to help relieve severe and potentially harmful diarrhea that can occur in patients who have intestinal tumors or suffer from metastatic carcinoid tumors. This medication does not eliminate the tumors but can offer patients relief from the many symptoms that are associated with this condition.

Octreotide is injected, either into a muscle or a vein, and patients are typically taught to self-administer the medication. If you are not an in-patient in a cancer treatment center or another clinic-like setting you will most likely administer this medication yourself.

Patients that are not comfortable with self-injection should speak with their doctor immediately to explore other options that are available to them. In addition to feeling comfortable with the injection, patients must also know how to properly prepare the skin for injection, and utilize a syringe to ensure proper measurement.

If you are taking octreotide and suffer from other major medical conditions, or are taking other medications, be sure that you provide a comprehensive medical history to your doctor and medical team. Inform your doctor of any allergies that you may have, including medications, food, animals, cleaning solutions and other substances. Your doctor should know about all prescription and non-prescription medications that you are taking as well as any herbal remedies and all vitamin and mineral supplements.

Do not alter the way that you take octreotide without first consulting with your doctor. If you do not find that the medication is effective or working as expected, it is important to address these concerns with your doctor right away. Do not take more of this medication if you do not feel relief from your symptoms right away, speak with your doctor first.

This medication should not be stored for longer than two weeks, and any vials or ampuls that are opened must be used right away. If the prescribed dosage amount is smaller than the amount of solution in the container the excess must be properly disposed of rather than kept for future use. Patients are advised to keep octreotide in the refrigerator.

Octreotide is produced with the following dosage delivery methods:

  • Powder for Suspension
  • Solution
  • Powder for Solution

Conditions Treated

  • Acromegaly
  • Severe diarrhea

Type Of Medicine

  • Somatostatin
  • Endocrine-Metabolic Agent

Side Effects

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 likely:

  • Abdominal or stomach pain
  • Unexplained tiredness or weakness
  • Constipation
  • Troubled breathing
  • Depressed mood
  • Severe stomach pain with nausea and vomiting
  • Dry mouth
  • Muscle cramps and stiffness
  • Fainting
  • Increased thirst
  • Feeling cold
  • Hoarseness or husky voice
  • Fruit-like breath odor
  • Hair loss
  • Weight gain
  • Increased hunger
  • Flushed, dry skin
  • Increased urination
  • Fast, slow, or irregular heartbeat
  • Nausea
  • Dry skin and hair
  • Sweating
  • Dizziness
  • Unexplained weight loss
  • Vomiting
  • Blurred vision

Less likely or rare occurrence:

  • Abdominal or stomach bloating
  • Headaches
  • Troubled breathing
  • Behavior change similar to drunkenness
  • Swelling of the front part of the neck
  • Cold sweats
  • Shakiness
  • Convulsions
  • Nightmares
  • Decreased sexual ability in males
  • Loss of appetite
  • Drowsiness
  • Muscle cramps and stiffness
  • Difficulties concentrating
  • Restless sleep
  • Cool, pale skin
  • Slurred speech
  • Confusion
  • Tiredness
  • Changes in menstrual periods
  • Unconsciousness
  • An anxious feeling
  • Unusual thirst

An unknown likelihood of incidence:

  • Black, tarry stools
  • Unusual bleeding or bruising
  • Blood in the urine or stools
  • Pinpoint red spots on the skin
  • Darkened urine
  • Yellow eyes or skin
  • Indigestion
  • Pains in the stomach, side, or abdomen
  • Fever
  • Severe constipation
  • Chills
  • Bleeding gums

These overdose symptoms will require immediate emergency medical attention:

  • Abdominal or stomach discomfort
  • Upper right abdominal or stomach pain
  • Diarrhea
  • Stopping of the heart
  • Fast, shallow breathing
  • Shortness of breath
  • A general feeling of discomfort
  • No blood pressure or pulse
  • Muscle pain or cramping
  • Weight loss
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Light-colored stools
  • Sleepiness
  • A feeling of warmth
  • Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • Dizziness, faintness, or lightheadedness
  • Weakness
  • Decreased appetite

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 healthcare 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 likely:

  • Passing of gas
  • Pain, redness, stinging, swelling, tingling, or burning feeling where injection occurred

Less likely and rare occurrence:

  • Backaches
  • Trouble concentrating
  • Cloudy urine
  • Sore throats
  • Difficult, burning, or painful urination
  • A runny nose
  • Double vision
  • Night blindness
  • Frequent urination usually with very small amounts of urine
  • Lower back or side pain
  • Halos around lights
  • Lack of appetite
  • Joint pain
  • Tunnel vision
  • Loss of vision
  • Itching skin
  • Muscle aches and pains
  • General feeling of discomfort or illness
  • Overbright appearance of lights
  • Frequent urge to urinate
  • Shivering
  • Disturbed color perception
  • Stools that float, are foul smelling, and fatty in appearance
  • Coughing
  • Trouble sleeping
  • Bladder pain

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

Dosage

The medication will be injected into either a muscle or vein and patients that do not require care in a hospital or another type of medical facility can be trained by their doctor or another member of their medical team to self-administer their dosage of octreotide at home. It is important that patients fully understand how to self-administer this drug before they begin the process. In addition to learning how to inject the medication, patients must also know how to properly prepare octreotide for injection.

Patients will be instructed to rotate the location in which they administer the medication, and inject themselves in a different location each time. This method will help to decrease the possibility of infection or irritation that can occur when multiple injections are given in the same spot over a short period of time.

Depending on the dosage amount that you are taking, there may be excess medication in either the ampul or vial that you are using. Do not save extra medication for use with another dose, as any leftover medication will need to be disposed of properly. Once the container has been opened, the contents must be used or discarded (excess solution) right away.

It is typical to feel some discomfort at the site of the injection, including a burning sensation, pain or tingling. One tip that has been reported to be effective is warming the solution to room temperature prior to injecting. This can be accomplished by removing the vial or ampul from the refrigerator prior to the time of your dosage; do not ever heat the medication as this can break down the medicine and cause it to become ineffective.

All used syringes and needles should be placed in a container that is puncture resistant; your doctor may offer other tips to follow for safe disposal of all equipment used in the injection process. Under no circumstances should any equipment such as syringes and needles be reused.

The guidelines outlined below reflect the typical dosage amounts used for octreotide and may differ from the amount that you have been prescribed to take. It is important to adhere to the prescription instructions that are provided by your doctor and not make any changes. If you feel that octreotide is not working effectively or as expected, discuss the situation with your doctor prior to making any changes to the way that you take the medicine.

  • Patients taking long-acting octreotide as a treatment for acromegaly:

20 milligrams will be taken initially by injecting the octreotide into the buttocks one time per month (or four weeks) for a period of three months. Following that first dosage, your physician will determine if the dosage amounts need to be adjusted.

  • Patients taking long-acting octreotide as a treatment for severe diarrhea and other conditions that occur in patients who suffer from intestinal tumors:

20 milligrams will be taken initially by injecting the octreotide into the buttocks one time per month (or four weeks) for a period of two months. Following that first dosage, your physician will determine if the dosage amounts need to be adjusted.

  • Patients taking short-acting octreotide as a treatment for acromegaly:

50 micrograms will be taken initially by injecting the octreotide, either under the skin or into a vein, three times every day. Following that first dosage, your physician will determine if the dosage amounts need to be adjusted.

  • Patients taking short-acting octreotide as a treatment for carcinoid tumors:

  • 100 to 600 micrograms will be taken every day during the first two weeks of treatment. This dosage will be taken by injection in two to four injections as instructed by your doctor. After the first two weeks of treatment, your physician will likely adjust your dose, with 1,500 micrograms the maximum daily dose.
  • For treatment of severe diarrhea that occurs with certain types of intestinal tumors:

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.

Patients who inadvertently miss a dose should take it as soon as they realize that it was skipped unless it is close to the time of the next scheduled dose. Do not ever take two doses to make up for one that has been missed. If you have skipped a dose and are unsure what to do, contact your prescribing physician or pharmacist for further guidance.

Major Drug Interactions:

There are certain medications that should not be used with octreotide and others that may cause complications or make the patient more likely to experience unwanted side effects. Your doctor should be aware of all medications that you are currently taking or have recently stopped taking prior to you starting octreotide. Be sure to include both prescription and non-prescription drugs, any herbal remedies that you are taking as well as all vitamin and mineral supplements.

Patients who are taking any of the drugs listed below may have their doctor switch them to an alternative medication prior to the start of their octreotide course of treatment. These drugs are contraindicated for use with octreotide:

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

The use of octreotide with the following group of medications is not typically recommended, and if the use of any of these drugs in combination with octreotide is prescribed, your doctor may alter the dosage and how you take one or both of them:

  • Acarbose
  • Zolmitriptan
  • Acetophenazine
  • Vinflunine
  • Albiglutide
  • Vemurafenib
  • Amiodarone
  • Vardenafil
  • Amoxapine
  • Triptorelin
  • Apomorphine
  • Trimethoprim
  • Aripiprazole
  • Triflupromazine
  • Asenapine
  • Trazodone
  • Azimilide
  • Tolbutamide
  • Bretylium
  • Thiethylperazine
  • Canagliflozin
  • Telithromycin
  • Chloroquine
  • Tedisamil
  • Chlorpropamide
  • Sunitinib
  • Citalopram
  • Sulpiride
  • Clomipramine
  • Spiramycin
  • Crizotinib
  • Sorafenib
  • Dabrafenib
  • Sodium Phosphate, Monobasic
  • Dasatinib
  • Sodium Phosphate
  • Delamanid
  • Sevoflurane
  • Deslorelin
  • Sematilide
  • Disopyramide
  • Salmeterol
  • Dolasetron
  • Risperidone
  • Donepezil
  • Ranolazine
  • Droperidol
  • Quinidine
  • Efavirenz
  • Protriptyline
  • Encainide
  • Propafenone
  • Erythromycin
  • Promazine
  • Ethopropazine
  • Procainamide
  • Fingolimod
  • Pramlintide
  • Fluconazole
  • Posaconazole
  • Fluphenazine
  • Pirmenol
  • Gatifloxacin
  • Pioglitazone
  • Glimepiride
  • Perphenazine
  • Glyburide
  • Pentamidine
  • Goserelin
  • Pasireotide
  • Halofantrine
  • Paliperidone
  • Halothane
  • Ofloxacin
  • Hydroquinidine
  • Norfloxacin
  • Hydroxyzine
  • Nateglinide
  • Iloperidone
  • Moxifloxacin
  • Insulin
  • Mifepristone
  • Insulin Bovine
  • Methotrimeprazine
  • Insulin Detemir
  • Metformin
  • Insulin Glulisine
  • Lumefantrine
  • Isoflurane
  • Lopinavir
  • Ivabradine
  • Liraglutide
  • Lapatinib
  • Lidoflazine
  • Levofloxacin
  • Linagliptin
  • Leuprolide
  • Lixisenatide
  • Ketoconazole
  • Lorcainide
  • Isradipine
  • Mefloquine
  • Insulin Lispro, Recombinant
  • Methadone
  • Insulin Glargine, Recombinant
  • Metronidazole
  • Insulin Degludec
  • Miglitol
  • Insulin Aspart, Recombinant
  • Nafarelin
  • Imipramine
  • Nilotinib
  • Ibutilide
  • Nortriptyline
  • Hydroxychloroquine
  • Ondansetron
  • Histrelin
  • Panobinostat
  • Haloperidol
  • Pazopanib
  • Granisetron
  • Perflutren Lipid Microsphere
  • Gonadorelin
  • Pimavanserin
  • Glipizide
  • Pipotiazine
  • Gemifloxacin
  • Pitolisant
  • Foscarnet
  • Prajmaline
  • Fluoxetine
  • Probucol
  • Flecainide
  • Prochlorperazine
  • Exenatide
  • Promethazine
  • Escitalopram
  • Propiomazine
  • Enflurane
  • Quetiapine
  • Empagliflozin
  • Quinine
  • Dulaglutide
  • Repaglinide
  • Doxepin
  • Rosiglitazone
  • Domperidone
  • Saxagliptin
  • Dofetilide
  • Sertindole
  • Dibenzepin
  • Sitagliptin
  • Desipramine
  • Sodium Phosphate, Dibasic
  • Degarelix
  • Solifenacin
  • Dapagliflozin
  • Sotalol
  • Cyclosporine
  • Sulfamethoxazole
  • Clozapine
  • Sultopride
  • Clarithromycin
  • Tacrolimus
  • Ciprofloxacin
  • Telavancin
  • Chlorpromazine
  • Tetrabenazine
  • Chloral Hydrate
  • Tolazamide
  • Buserelin
  • Toremifene
  • Azithromycin
  • Trifluoperazine
  • Astemizole
  • Trimeprazine
  • Arsenic Trioxide
  • Trimipramine
  • Aprindine
  • Vandetanib
  • Anagrelide
  • Vasopressin
  • Amitriptyline
  • Vildagliptin
  • Alogliptin
  • Voriconazole
  • Ajmaline
  • Zotepine
  • Acecainide
  • Zuclopenthixol

The use of octreotide with the following drug may prompt your doctor to order more diagnostic testing or they may alter the way that you take one or both of the medications:

  • Pegvisomant

Inform your doctor of any lifestyle habits that you have, such as using tobacco or drinking alcohol regularly, as these activities may alter the way that your body reacts to octreotide.

Patients who suffer from the following medical conditions may experience unwanted side effects, or they may experience some complications to their conditions with the use of octreotide. If you have any of the ailments listed below, be sure to notify your doctor of any severe reactions that you experience while taking octreotide:

  • Cholangitis
  • Vitamin B12 deficiency
  • Gallbladder disease
  • Pancreatitis
  • Heart rhythm problems
  • Kidney disease
  • Thyroid problems
  • Gallstones
  • Diabetes
  • Congestive heart failure

Warnings

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 medicines and herbal or vitamin supplements).

Storage

Octreotide should be stored in the refrigerator and never frozen. Any excess, unused, or expired medication should be disposed of properly. If your dosage is less than the amount of solution that comes in the vial or ampul, dispose of the excess rather than saving it for future use. Once the ampul or vial has been opened its contents should be used right away.

Patients who are taking the short-acting version of this medication are able to leave the solution at room temperature up to two weeks as long as the container is shielded from direct light. If the solution becomes cloudy or there are noticeable particles in it, it should be disposed of and not used.

Keep this and all medications out of the reach of pets and small children.

If you are unsure how to safely dispose of excess medication as well as the equipment used to inject it, confer with your prescribing physician or pharmacist for further guidance.

Summary

Patients who suffer from acromegaly, a condition caused by the overproduction of growth hormone, have found relief with the use of the injected drug known as octreotide. This prescription medication can help in reducing the amount of growth hormone that is produced and helps to alleviate the symptoms commonly associated with this malady. Patients typically report large, thick, and bulky areas of their body, mainly their face, hands, and feet, that can cause extreme discomfort. This disorder can also spur the development of arthritis in some patients.

This medication is also used to help relieve severe and potentially harmful diarrhea that can occur in patients who have intestinal tumors or suffer from metastatic carcinoid tumors. This medication does not eliminate the tumors but can offer patients relief from the many symptoms that are associated with this condition.

Octreotide is injected, either into a muscle or a vein, and patients are typically taught to self-administer the medication. If you are not an in-patient in a cancer treatment center or another clinic-like setting you will most likely administer this medication yourself.

Patients that are not comfortable with self-injection should speak with their doctor immediately to explore other options that are available to them. In addition to feeling comfortable with the injection, patients must also know how to properly prepare the skin for injection, and utilize a syringe to ensure proper measurement.

This medication should not be stored for longer than two weeks, and any vials or ampuls that are opened must be used right away. If the prescribed dosage amount is smaller than the amount of solution in the container the excess must be properly disposed of rather than kept for future use. Patients are advised to keep octreotide in the refrigerator.