Octreotide: Uses, Warnings, Side Effects, Dosage

Generic Name: octreotide

Brand Names: Sandostatin, Sandostatin LAR, Bynfezia Pen, Mycapssa

Drug Class: Antidiarrheals; Somatostatin Analogs

What is octreotide, and what is it used for?

Octreotide is a medication used in the treatment of acromegaly, a disorder associated with excessive blood levels of growth hormone, and severe, watery diarrhea caused by certain types of gastrointestinal (GI) tumors. Octreotide is a somatostatin analog that is structurally similar to and mimics the activity of somatostatin, a natural hormone that inhibits growth hormone and various gastrointestinal hormones involved in the digestive process. Acromegaly causes excessive growth of body tissues, typically characterized by abnormally large hands, feet and face, and metabolic dysfunction. It may cause enlargement of internal organs and insulin resistance, and can be life-threatening. Most often, acromegaly is the result of an anterior pituitary growth hormone-releasing tumor. Carcinoid tumors are a type of slow-growing cancer of hormone-secreting nerve cells (neuroendocrine) that can grow anywhere in the body. Gastrointestinal carcinoid tumors cause severe diarrhea and flushing. Octreotide works by binding to protein particles (receptors) on cells that respond to somatostatin and inhibit their activity. This suppresses secretion of growth hormone from pituitary gland and insulin-like growth factor-1 (IGF-1) from liver, reducing the metabolic and other symptoms of acromegaly. Octreotide also suppresses the response of the reproductive hormone luteinizing hormone (LH) to gonadotropin-releasing hormone (GnRH), and the pancreatic secretion of glucagon and insulin, the two hormones that regulate blood glucose levels. In the gastrointestinal tract, octreotide reduces visceral (splanchnic) blood flow and inhibits the release of serotonin and secretion of various gastrointestinal hormones including gastrin, vasoactive intestinal peptide, secretin, motilin, and pancreatic polypeptide, reducing the hormone release by gastrointestinal tumors and resultant diarrhea. Uses of octreotide include: Adult: FDA-approved:

• Acromegaly
• Carcinoid tumors
• Vasoactive intestinal peptide-secreting tumors (VIPomas)

Off-label:

• Carcinoid crisis
• Esophageal variceal bleeding
• Gastrointestinal or pancreatic fistula
• Gastroenteropancreatic neuroendocrine tumors
• Diarrhea associated with acute graft-versus-host disease (GVHD)
• Acquired immunodeficiency syndrome (AIDS)-related diarrhea
• Ileostomy-related diarrhea
• Chemotherapy-related diarrhea
• Dumping syndrome
• Chylothorax, a disorder with lymphatic fluid collection in the chest
• Hepatorenal syndrome type 1 or acute kidney injury
• Hypoglycemia, sulfonylurea-induced
• Malignant bowel obstruction
• Advanced thymic epithelial malignancies

Pediatric:

Off-label:

• Gastrointestinal bleeding
• Diarrhea
• Chylothorax
• Hyperinsulinemia/hypoglycemia in infancy
• Sulfonylurea overdose

Warnings

• Do not use in patients with hypersensitivity to any of the components in octreotide.
• Octreotide may inhibit contractility of gallbladder and bile secretion. Monitor patients for gallstones and impairment of gallbladder function.
• Octreotide alters the balance between insulin, glucagon, and growth hormone levels which may alter blood glucose levels. Monitor patient’s blood sugar levels and adjust antidiabetic medications appropriately.
• Octreotide suppresses the secretion of thyroid-stimulating hormone, which may cause hypothyroidism. Monitor the patient’s thyroid function periodically.
• Cardiac function abnormalities including irregular rhythms (arrhythmias), slow or rapid heart rate (bradycardia/tachycardia), and other conduction problems have been reported with octreotide therapy. Use with caution in patients with pre-existing heart disease and adjust the cardiac medications as necessary.
• Octreotide may alter absorption of dietary fats, monitor the patient for pancreatitis.
• Octreotide may impair absorption of vitamin B12, monitor the patient’s B12 levels.
• Use with caution in liver or kidney impairment and adjust dose if necessary.
• Octreotide reduces excessive fluid loss from the GI tract which may result in abnormally high zinc levels in patients receiving total parenteral nutrition (TPN). Monitor zinc levels in such patients periodically.
• Octreotide may restore fertility and lead to unintended pregnancy. Women of reproductive potential who do not wish to become pregnant should use effective contraception during therapy.

SLIDESHOW

What are the side effects of octreotide?

Common side effects of octreotide include:

• Headache
• Dizziness
• Fatigue
• Pain at injection site
• Abdominal distress
• Abdominal pain
• Diarrhea
• Flatulence
• Constipation
• Nausea
• Vomiting
• Dry mouth (xerostomia)
• Biliary tract disease including: Gall bladder inflammation (cholecystitis) Gall bladder sludge Gallstones (cholelithiasis) Biliary obstruction Liver inflammation from impaired bile flow (cholestatic hepatitis) Jaundice Inflammation of the ascending bile duct (ascending cholangitis)
• Gall bladder inflammation (cholecystitis)
• Gall bladder sludge
• Gallstones (cholelithiasis)
• Biliary obstruction
• Liver inflammation from impaired bile flow (cholestatic hepatitis)
• Jaundice
• Inflammation of the ascending bile duct (ascending cholangitis)
• Abdominal distension
• Indigestion (dyspepsia)
• Fecal discoloration
• Gastritis
• Gastroesophageal reflux disease (GERD)
• Gastrointestinal motility disorder
• Malabsorption
• Excessive fat excretion in stools (steatorrhea)
• Frequent urge to pass stools (tenesmus)
• Hemorrhoids
• Abnormally slow heart rhythm (sinus bradycardia)
• Irregular heart rhythm (cardiac arrhythmia)
• Cardiac conduction disturbance
• Rapid heart rate (tachycardia)
• High blood pressure (hypertension)
• Flushing
• Swelling (edema)
• Excessive sweating (diaphoresis)
• Hair loss (alopecia)
• Itching (pruritus)
• High blood sugar levels (hyperglycemia)
• Diabetes mellitus
• Low blood sugar (hypoglycemia)
• Low thyroid activity (hypothyroidism)
• Goiter
• Decrease in free T4 thyroid hormone
• Increase in thyroid stimulating hormone (TSH) level
• Antibody development to octreotide
• Flu-like symptoms
• Influenza
• Cold-like symptoms
• Low red blood cell count (anemia)
• Bruise
• Hematoma at injection site
• Joint pain (arthralgia)
• Weakness (asthenia)
• Back pain
• Depression
• Blurred vision
• Visual disturbance
• Inflammation of nose and throat (nasopharyngitis)
• Upper respiratory tract infection
• Urinary tract infection
• Frequent daytime urination (pollakiuria)

Less common side effects of octreotide include:

• Appendicitis
• Gastric/peptic ulcer
• Intestinal polyp
• Intestinal obstruction
• Gastrointestinal hemorrhage
• Abdominal swelling
• Necrotizing enterocolitis
• Hepatitis
• Fatty liver disease (liver steatosis)
• Increase in liver enzymes
• Gall bladder polyp
• Spots on skin from bleeding underneath (petechiae)
• Basal cell carcinoma, a type of skin cancer
• Breast carcinoma
• Low platelet count in blood (thrombocytopenia)
• Low count of all types of blood cells (pancytopenia)
• Chest pain
• Heart failure
• Hypertensive crisis
• Heart attack (myocardial infarction)
• Palpitations
• Atrial fibrillation
• Drop in blood pressure with standing up from sitting or lying down (orthostatic hypotension)
• Reduced blood flow (ischemia)
• Raynaud’s disease
• Inflammation of vein with blood clots (thrombophlebitis)
• Blood clot in the artery (arterial thrombosis) in the arm
• Bulge in blood vessel (aneurysm)
• Fainting (syncope)
• Facial edema
• Skin rash
• Hives (urticaria)
• Cellulitis
• Hypersensitivity reaction
• Severe allergic reaction (anaphylaxis)
• Anaphylactic shock
• Adrenocortical insufficiency
• Pituitary apoplexy
• Diabetes insipidus
• Reduced libido
• Menstrual disease
• Infrequent menstruation
• Absence of menstruation (amenorrhea)
• Abnormal breast tissue growth in males (gynecomastia)
• Abnormal breast milk secretion (galactorrhea)
• Iron deficiency
• Vitamin B12 deficiency
• Weight loss
• Vaginal inflammation (vaginitis)
• Kidney stones (nephrolithiasis)
• Blood in urine (hematuria)
• Renal insufficiency
• Renal failure syndrome
• Increase in serum creatinine
• Shortness of breath (dyspnea)
• Pneumonia
• Severe acute asthma (status asthmaticus)
• Lung collapse (pneumothorax)
• Pulmonary hypertension
• Pulmonary nodule
• Nasal bleed (epistaxis)
• Increased intraocular pressure
• Glaucoma, a condition that damages the optic nerve
• Blind spot in vision (scotoma)
• Blood clot in the retina (retinal thrombosis)
• Hearing loss
• Ear inflammation (otitis)
• Loss of memory (amnesia)
• Anxiety
• Paranoid ideation
• Suicidal tendencies
• Language and communication difficulty (aphasia)
• Nerve inflammation (neuritis)
• Bell’s palsy
• Vertigo
• Tremor
• Seizure
• Weakness and impaired movement on one side of the body (hemiparesis)
• Weakness in the entire body (paresis)
• Migraine
• Intracranial hemorrhage
• Joint inflammation (arthritis)
• Joint effusion
• Muscle pain (myalgia)
• Increase in creatine phosphokinase (CPK) levels in blood

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Health News

What are the dosages of octreotide?

Capsule, Delayed-Release (Mycapssa)

• 20 mg

Injectable Solution (Sandostatin)

• 0.05 mg/mL
• 0.1 mg/mL
• 0.2 mg/mL
• 0.5 mg/mL
• 1 mg/mL

Depot Injection (Sandostatin LAR Depot)

• 10 mg/kit
• 20 mg/kit
• 30 mg/kit

Injectable Solution (Bynfezia Pen)

• 2500 mcg/mL (single-patient-use pen)

Adult:

Acromegaly

Reduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) [somatomedin C] in adults with acromegaly who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and bromocriptine mesylate at maximally tolerated doses

Bynfezia Pen

• 50 mcg subcutaneous (SC) thrice daily initially
• Usual dose: 100 mcg SC thrice daily; some patients require up to 500 mcg thrice daily
• Doses higher than 300 mcg/day seldom result in additional benefit; if an increase in dose fails to provide additional benefit, reduce dosage
• Dosing titration Measure IGF-I levels every 2 weeks after initiation or dosage change Alternatively, measuring growth hormone levels at 1-4-hour intervals for 8-12 hours after administration; goal is to achieve growth hormone levels below 5 ng/mL or IGF-I levels within normal reference ranges for age and sex Once biochemical normalization, or maximal benefit is achieved, re-evaluate IGF-I or growth hormone levels at 6-month intervals
• Measure IGF-I levels every 2 weeks after initiation or dosage change
• Alternatively, measuring growth hormone levels at 1-4-hour intervals for 8-12 hours after administration; goal is to achieve growth hormone levels below 5 ng/mL or IGF-I levels within normal reference ranges for age and sex
• Once biochemical normalization, or maximal benefit is achieved, re-evaluate IGF-I or growth hormone levels at 6-month intervals

Sandostatin LAR depot

Patients not currently receiving octreotide

• Begin therapy with solution as listed above
• Maintain on SC solution for at least 2 weeks as listed above to determine tolerance to octreotide
• Patients who respond to the drug, based on GH and IGF-1 levels and who tolerate the drug, then switch to octreotide suspension

Patients currently receiving octreotide

• Switch to octreotide suspension 20 mg intramuscular/IM (gluteal) every 4 weeks for 3 months; titrate up or down to 10-30 mg IM every 4 weeks, depending on response; not to exceed 40 mg
• After 3 months, dosage may be adjusted as follows: GH 2.5 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: Maintain octreotide suspension at 20 mg every 4 weeks GH higher than 2.5 ng/mL, IGF-1 elevated, and/or clinical symptoms uncontrolled: Increase octreotide suspension to 30 mg every 4 weeks GH 1 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: Reduce octreotide suspension to 10 mg every 4 weeks If GH, IGF-1, or symptoms are not adequately controlled at a dose of 30 mg, the dose may be increased to 40 mg every 4 weeks; doses higher than 40 mg are not recommended In patients who have received pituitary irradiation, withdraw yearly for 8 weeks to assess disease activity; if GH or IGF-1 levels increase and signs and symptoms recur, resume therapy
• GH 2.5 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: Maintain octreotide suspension at 20 mg every 4 weeks
• GH higher than 2.5 ng/mL, IGF-1 elevated, and/or clinical symptoms uncontrolled: Increase octreotide suspension to 30 mg every 4 weeks
• GH 1 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: Reduce octreotide suspension to 10 mg every 4 weeks
• If GH, IGF-1, or symptoms are not adequately controlled at a dose of 30 mg, the dose may be increased to 40 mg every 4 weeks; doses higher than 40 mg are not recommended
• In patients who have received pituitary irradiation, withdraw yearly for 8 weeks to assess disease activity; if GH or IGF-1 levels increase and signs and symptoms recur, resume therapy

Mycapssa

• 20 mg orally twice daily (40 mg/day) initially
• May titrate up in increments of 20 mg/day, based on IGF-1 levels and signs and symptoms; maximum dosage is 80 mg/day
• Monitor IGF-1 levels and signs and symptoms every 2 weeks during the dose titration, monthly during maintenance dosage, or as indicated
• For 60 mg/day dose, administer as 40 mg in the morning and 20 mg in the evening
• Dosage interruptions and modifications If IGF-1 levels remain above the UNL after treatment with the maximum recommended dosage of 80 mg/day or the patient cannot tolerate treatment, consider discontinuing treatment and switching patient to another somatostatin analog Withdraw therapy periodically to assess disease activity If IGF-1 levels increase and signs and symptoms recur, resume therapy
• If IGF-1 levels remain above the UNL after treatment with the maximum recommended dosage of 80 mg/day or the patient cannot tolerate treatment, consider discontinuing treatment and switching patient to another somatostatin analog
• Withdraw therapy periodically to assess disease activity
• If IGF-1 levels increase and signs and symptoms recur, resume therapy

Indicated for treatment of adults with severe diarrhea and flushing episodes associated with metastatic carcinoid tumors

Bynfezia Pen

• 100-600 mcg/day SC in 2-4 divided doses for the first 2 weeks
• In clinical studies, median daily maintenance dosage was 450 mcg, but clinical and biochemical benefits were obtained in some patients ranged from 50-1,500 mcg/day
• Experience with doses higher than 750 mcg/day is limited
• Monitor urinary 5-hydroxyindole acetic acid (5-HIAA), plasma serotonin, and plasma substance

Sandostatin LAR depot

Patients not currently receiving octreotide

• Begin therapy with solution as listed above
• Maintain on SC solution for at least 2 weeks as listed above to determine tolerance to octreotide
• Patients who respond to the drug, based on GH and IGF-1 levels and who tolerate the drug, then switch to octreotide suspension

Patients currently receiving octreotide

• 20 mg IM every 4 weeks for 2 months then modify dose based on response; may increase to 30mg every 4 weeks if symptoms are inadequately controlled; decrease to 10 mg IM every 4 weeks for trial period if initially responsive to 20 mg dose; dose higher than 30 mg not recommended
• Patients who have periodic exacerbation of symptoms (regardless of whether they are being maintained on Sandostatin injection or Sandostatin LAR Depot)
• During these periods, SC Sandostatin injection may be given for a few days at the dosage they were receiving prior to switching to Sandostatin LAR depot; once symptoms resolve; discontinue SC Sandostatin injection

VIPoma

Indicated for treatment of adults with the profuse watery diarrhea associated with VIP-secreting tumors

Bynfezia Pen

• 200-300 mcg/day SC in 2-4 divided doses for the first 2 weeks
• Adjust dosage to achieve a therapeutic response; daily dosage is 150-750 mcg but usually doses higher than 450 mcg/day are not required
• Monitor plasma vasoactive intestinal peptide (VIP)

Sandostatin LAR depot

Patients not currently receiving octreotide

• Begin therapy with solution as listed above
• Maintain on SC solution for at least 2 weeks as listed above to determine tolerance to octreotide
• Patients who respond to the drug, based on GH and IGF-1 levels and who tolerate the drug, then switch to octreotide suspension

Patients currently receiving octreotide

• 20 mg IM every 4 weeks for 2 months then modify dose based on response; may increase to 30mg every 4 weeks if symptoms are inadequately controlled; decrease to 10 mg IM every 4 weeks for trial period if initially responsive to 20 mg dose; dose higher than 30 mg not recommended
• Patients who have periodic exacerbation of symptoms (regardless of whether they are being maintained on Sandostatin injection or Sandostatin LAR Depot)
• During these periods, SC Sandostatin injection may be given for a few days at the dosage they were receiving prior to switching to Sandostatin LAR depot; once symptoms resolve; discontinue SC Sandostatin injection

Esophageal Variceal Bleeding (Off-label)

• Solution: 25-100 mcg intravenous (IV) bolus (usual bolus dose: 50 mcg); follow by continuous IV infusion of 25-50 mcg/hour for 2-5 days; may repeat bolus in first hour if hemorrhage not controlled

GI or Pancreatic Fistula (Off-label)

• Solution: 50-200 mcg SC every 8 hours for 2-12 days

AIDS-Related Diarrhea (Off-label)

• Solution: 100-500 mcg SC every 8 hours

Ileostomy-Related Diarrhea (Off-label)

• Solution: 25 mcg/hour IV or 50 mcg SC every 12 hours

Chemotherapy-Related Diarrhea (Off-label)

• Low-grade or uncomplicated: Solution: 100-150 mcg SC every 8 hours for 1-30 days
• Complicated: Solution: 100-150 mcg SC every 8 hours or 25-50 mcg/hour IV; may increase to 500 mcg every 8 hours until controlled
• Severe: Solution: 100-150 mcg SC every 8 hours; may increase to 500-1500 mcg SC/IV every 8 hours

Dumping Syndrome (Off-label)

• Solution: 50-150 mcg/day IV; may adjust to 25-600 mcg/day dose range
• Suspension (depot injection): 10-20 mg/month IM

Chylothorax (Off-label)

• Solution: 50-100 mcg SC every 8 hours

Dosage Modifications

Coadministration with proton pump inhibitors, H2-receptor antagonists, or antacids

• Mycapssa only
• Concomitant use of oral octreotide and proton pump inhibitors, H2-receptor antagonists, or antacids may require increased dosages of oral octreotide

Renal impairment

• Sandostatin or Sandostatin LAR depot Mild-to-severe without dialysis: No dosage adjustment necessary With dialysis: 10 mg IM every 4 weeks initially, then titrate to effect
• Mild-to-severe without dialysis: No dosage adjustment necessary
• With dialysis: 10 mg IM every 4 weeks initially, then titrate to effect
• Mycapssa Mild-to-severe: No dosage adjustment necessary End-stage renal disease: 20 mg orally every day initially, then titrate to effect
• Mild-to-severe: No dosage adjustment necessary
• End-stage renal disease: 20 mg orally every day initially, then titrate to effect
• Bynfezia Pen Patients on dialysis: Half-life of octreotide may increase, may require dosage adjustment on maintenance dose
• Patients on dialysis: Half-life of octreotide may increase, may require dosage adjustment on maintenance dose

Hepatic impairment

• Sandostatin or Sandostatin LAR depot Cirrhosis: 10 mg IM every 4 weeks initially, then titrate to effect
• Cirrhosis: 10 mg IM every 4 weeks initially, then titrate to effect
• Mycapssa Patients with liver cirrhosis and patients with fatty liver disease showed prolonged elimination of octreotide following SC administration
• Patients with liver cirrhosis and patients with fatty liver disease showed prolonged elimination of octreotide following SC administration

Geriatric:

Acromegaly

• Solution: 50 mcg SC every 8-12 hours initially; titrate up to 500 mcg SC every 8 hours if necessary; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
• Suspension (depot injection): 20 mg IM intragluteally every 4 weeks for 3 months; titrate up or down to 10-30 mg IM every 4 weeks, depending on response; not to exceed 40 mg

Dosing Considerations

• Dose adjustment may be necessary; clearance may decrease by 26% and half-life by 46%
• Monitor IGF-1 levels every 2 weeks to guide titration; goal: GH levels less than 5 ng/mL or IGF-1 levels less than 1.9 units/mL (men) and less than 2.2 units/mL (women)
• Monitor IGF-1 or GH levels every 6 months
• Withdraw drug yearly for 4 weeks (solution) or 8 weeks (suspension) from patients who have undergone irradiation to assess

Carcinoid Tumor

• Solution: 100-600 mcg/day SC divided every 6-12 hours; may titrate to 1500 mcg/day; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
• Suspension (depot injection): 20 mg IM every 4 weeks if regular injection well tolerated

VIPoma

• Solution: 200-300 mcg/day SC divided every 6-12 hours; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
• Suspension (depot injection): 20 mg IM (gluteal) every 4 weeks for 2 months; continue solution for first 2 weeks; titrate suspension up or down to 10-30 mg IM every 4 weeks

Esophageal Variceal Bleeding (Off-label)

• Solution: 50 mcg IV bolus, then 25-50 mcg/hour for 1-5 days

Pediatric:

• Safety and efficacy not established

GI Bleeding (Off-label)

• 1 mcg/kg bolus, then 1 mcg/kg/hour infusion; taper by 50% when no active bleeding for 24 hours

Diarrhea (Off-label)

• 1-10 mcg/kg/day IV/SC

Chylothorax (Off-label)

• 0.3-4 mcg/kg/hour SC/IV, depending on nature of chylothorax

Hyperinsulinemia/Hypoglycemia of Infancy (Off-label)

• 2-10 mcg/kg/day SC/IV divided every 12 hours; increase on basis of response

Sulfonylurea Overdose (Off-label)

• 1 mcg/kg SC/IV every 12 hours OR 25 mcg once; monitor blood glucose concentrations

Overdose

• Octreotide overdose may cause irregular heart rhythm (arrhythmia), low blood pressure (hypotension), cardiac arrest, low oxygen in brain tissue (brain hypoxia), pancreatitis, fatty liver disease (hepatitis steatosis), liver enlargement (hepatomegaly), lactic acidosis, flushing, diarrhea, lethargy, weakness, and weight loss.
• Overdose treatment includes supportive and symptomatic care.

What drugs interact with octreotide?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Severe Interactions of octreotide include: disopyramide ibutilide indapamide pentamidine pimozide procainamide quinidine sotalol
• disopyramide
• ibutilide
• indapamide
• pentamidine
• pimozide
• procainamide
• quinidine
• sotalol
• Octreotide has serious interactions with at least 70 different drugs.
• Octreotide has moderate interactions with at least 94 different drugs.
• Mild interactions of octreotide include:

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or healthcare provider from all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or healthcare provider if you have any questions about the medication.

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Pregnancy and breastfeeding

• Octreotide may be used in women with acromegaly who wish to become pregnant. The drug should be discontinued once pregnancy occurs.
• Octreotide improves fertility and may result in unintended pregnancy in premenopausal women.
• Animal studies showed transient growth retardation in the fetus, with no impact on postnatal development and there was no other evidence of octreotide-related adverse effects on fetal development.
• Available reports from octreotide use in pregnant women are insufficient to identify drug-associated risks of major birth defects, miscarriage or adverse maternal or fetal outcomes.
• Use octreotide during pregnancy only if clearly needed. If treatment for acromegaly is required during pregnancy, use the lowest effective dose.
• There is no information on the presence of octreotide in breast milk, or its effects on milk production or on the breastfed infant, however, the drug is present in animal milk. The decision to breastfeed during octreotide therapy should be made considering the mother’s clinical need, and the benefits of breastfeeding, risks from the mother’s underlying condition, and risks of drug exposure to the infant.

What else should I know about octreotide?

• Take octreotide capsules exactly as prescribed.
• Contact your healthcare provider if you:
• You may need to be tested periodically for thyroid function, vitamin B12 levels, or other parameters periodically. Follow up with your healthcare provider.
• Store carefully out of reach of children.
• In case of overdose, seek immediate medical help or call Poison Control.

Summary

Octreotide is a medication used in the treatment of acromegaly, a disorder associated with excessive blood levels of growth hormone, and severe, watery diarrhea caused by certain types of gastrointestinal (GI) tumors. Common side effects of octreotide include headache, dizziness, fatigue, pain at injection site, abdominal distress, abdominal pain, diarrhea, flatulence, constipation, nausea, vomiting, dry mouth (xerostomia), biliary tract disease, and others. Do not take if pregnant or breastfeeding.

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• Do All Cancers Show Up on Blood Tests? Blood tests are usually done in all cases of suspected cancer and may also be done routinely in healthy individuals. Not all cancers show up on blood tests.
• Can You Eat Eggs When You Have Diarrhea? In most individuals with diarrhea, eggs help slow down bowel movements and help the patient recover faster from diarrhea. Cooking them makes them easier to digest.
• When Should You Worry About Diarrhea? Diarrhea is typically a symptom that resolves itself within 48 hours; however, here is when it may indicate a serious health issue.
• Where Is Colon Cancer Pain Felt? Colon cancer is cancer of the last part of the large intestine. Colon cancer pain is generally felt as vague abdominal pain or cramps.
• Does Stomach Cancer Pain Come and Go? Stomach cancer, also known as gastric cancer, develops in the lining of the stomach. Stomach cancer tends to develop slowly over many years.
• Is Any Stage IV Cancer Curable? Stage IV cancer is rarely curable. However, not all stage IV cancers are terminal, and survival rates vary depending on the specifics of each case and available treatment options.
• How Do You Get Rid of Diarrhea? Diarrhea is characterized as loose or runny stools that happen an abnormally high number of times throughout the day. Diarrhea can be linked to autoimmune diseases like Crohn’s or irritable bowel syndrome but is more often a sign of food intolerance (lactose is common), viral infection, food poisoning, or other infectious diseases of varying severity.
• Bile Duct Cancer (Cholangiocarcinoma) Bile duct cancer (cholangiocarcinoma) is a rare type of cancer that arises from cells that line the drainage system from the liver and gallbladder to the intestine. Symptoms and signs of bile duct cancer include jaundice, itching, weight loss, and abdominal pain. Physical examination, specialized blood tests, and imaging tests may be used to diagnose bile duct cancer. Treatment for bile duct cancer may include chemotherapy, radiation therapy, and photodynamic therapy. Bile duct cancer typically has a poor prognosis. Preventing liver damage may decrease the risk of developing bile duct cancer.
• Can Cancer Be Detected by a Blood Test? While blood tests can’t absolutely detect all cancers, certain blood tests can give your doctor an idea of how your organs are functioning and if they have been affected by cancer. No blood test can detect colon cancer. However, your doctor may order blood tests to get a picture of your overall health and use other screening methods to look for signs of colon cancer.
• Does Sprite Help With Diarrhea? Diarrhea causes the body to lose fluids, leading to dehydration. Sugary drinks, such as Sprite, may not be high up on the list of recommended fluids in case of diarrhea. If you don't have any other options but to drink Sprite, it may be a good idea to add some water to it and let the bubbles fizz out before drinking it.
• Traveler's Diarrhea Traveler's diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of traveler's diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of traveler's diarrhea. Five unique classes of E. coli cause gastroenteritis. Other bacteria responsible for traveler's diarrhea include Campylobacter, jejuni, shigella, and salmonella. Viruses, such as rotavirus and Norwalk virus (norovirus), and giardia lamblia, a parasite, may cause traveler's diarrhea. Prevention is careful eating and drinking of water.
• Cancer Risk Factors and Causes Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
• How Can You Manage IBS-D? What Are The Foods To Avoid? IBS-D or irritable bowel syndrome with diarrhea refers to IBS with diarrhea. Symptoms of IBS-D include intestinal gas (flatulence), loose stools, frequent stools, abdominal pain, diarrhea, and nausea. New non-FDA-approved IBS tests may help diagnose IBS and IBS-D. Treatment of IBS-D is geared toward managing symptoms with diet, medication, and lifestyle changes.
• Pain From Liver Cancer Patients suffering from liver cancer usually complain of a throbbing or stabbing sensation in the upper right side of the abdomen or the back of the shoulder. There may or may not be a swelling that doesn’t subside. The pain may be severe; it is graded 7/10 in intensity. Some patients may not have any symptoms in the early stages of liver cancer.
• What Is the Difference Between Diarrhea and Dysentery? Learn the difference between diarrhea and dysentery. Discover the symptoms and medical treatments for each.
• Can Cancer Be Detected in Blood Tests? While doctors may perform a variety of tests to help diagnose cancer, except for blood cancers, blood tests alone cannot diagnose cancer. However, they can give clues about the health condition of the body.
• At What Stage of Cancer is Chemotherapy Used? The decision to use chemotherapy may vary depending on the aggressiveness, stage and type of cancer. Usually, chemotherapy may be used for all stages in most cancer types. Chemotherapy is a type of medicine or combination of medications that is used to treat or kill cancer cells.
• What Stops Diarrhea Fast? Diarrhea or loose stools may be caused by an infection, parasites, certain medications, intestinal disease, food intolerance, hormone disorders, bowel cancer or lactose intolerance. You can stop diarrhea fast with one of two different kinds of over-the-counter medication, Imodium (loperamide) or Kaopectate or Pepto-Bismol (bismuth subsalicylate).
• What Can Diarrhea Be a Sign Of? Diarrhea is a common condition and usually goes away without intervention.
• Early Signs of Colon Cancer Colon or colorectal cancer may not cause any symptoms during the early stages of the disease. A person may have polyps or colon cancer but may not have any symptoms till the late stages of the disease.
• How Long Does Diarrhea Last for a Baby? Diarrhea in babies typically lasts for 3-7 days, depending on the cause. If your baby’s diarrhea lasts longer, it may indicate a more serious problem.
• Cancer Pain Cancer pain is a common experience that may result from the disease, treatment, or diagnostic procedure. Check out the center below for more medical references on cancer, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
• Is Kidney Cancer Curable? Kidney cancer is an uncontrolled division of cells (cancer) that begins in the kidney. How curable is a particular cancer depends on its stage, its cell type, and the stage at which it is diagnosed.
• Can Diarrhea Be an Initial Symptom of COVID-19? COVID-19 has become a common illness that affects many people. Learn the signs of COVID-19, what causes it, how doctors diagnose it, and what you can do to treat it.
• Do Blood Tests Show Pancreatic Cancer? Blood tests are often used in combination with other clinical assessments and tests to diagnose pancreatic cancer.
• What Are the Three Top Cancer Killers? Cancer is a group of diseases that occur when abnormal cells spread uncontrollably throughout the body. The top three cancer killers are lung cancer, colorectal cancer, and breast cancer.
• Acromegaly and Gigantism: Differences Acromegaly and gigantism are both caused by the excess secretion of growth hormones, but there are notable differences between the two disorders. Learn about acromegaly vs. gigantism and check out the center below for more medical references on hormonal disorders, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
• How Is Kidney Cancer Diagnosed? Kidney cancer is usually asymptomatic in earlier stages. The tumor is usually found when a patient undergoes medical tests for another reason. A doctor may order the following tests to confirm the diagnosis.

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https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/019667s058,021008s023lbl.pdf

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