Critical Care Trauma Centre

OCTREOTIDE (Sandostatin)

Name: OCTREOTIDE (SandostatinR)
Classification: synthetic octapeptide analogue of naturally occurring somatostatin
  • inhibits pathologically increased secretion of peptides and serotonin produced within the gastroentero-pancreatic (GEP) endocrine system and growth hormone, thus used in pancreatitis or post pancreatic surgery to prevent complications such as pancreatic fistula or abscess
  • thought to reduce splanchnic blood flow primarily by inhibiting vasoactive gastrointestinal hormone secretion and exerting a direct vasomotor effect on splanchnic vessels, thus reducing portal blood flow;  used in the emergency management of bleeding gastroesophageal varices in patients with cirrhosis
Dose: Gastrointestinal bleeding
  • 50 - 100 ug IV bolus
  • 25 - 50 ug/hour IV infusion for 1 to 5 days
     

To reduce gastrointestinal output or pancreatic fistula secretions:

  • 50 - 200 ug every 8 hours or 250 ug/hour by continuous infusion for 48 hours (followed by subcuntaneous dosing)
Administration:

SC dose:  ensure site rotated with each dose

IV Bolus dose:

  • 50 ug in 50 mL sodium chloride 0.9% or dextrose 5% over 10 minute

IV Infusion:

  • 500 ug in 250 mL sodium chloride 0.9% or dextrose 5%
Adverse Effects: 
  
  
  
  
  
 

 

Cardiovascular:

  • flushing, edema, chest pain, congestive heart failure
  • palipitations
  • hypertension, orthostatic hypotension
  • sinus bradycardia or conduction abnormalities

Neurological:

  • Bell's Palsy
  • fatigue
  • vertigo, dizziness
  • anxiety, depression, insomnia
  • seizures, hyperesthesia, chills

Respiratory:

  • shortness of breath
  • rhinorrhea
     

Endocrine:

  • hyper- or hypo-glycemia
  • galactorrhea, hypothyroidism

Dermatologic:

  • erythema, puritis
  • alopecia
  • bruising
  • injection site pain (SC)

Gastrointestinal:

  • altered absoprtion of dietary fats, steatorrhea
  • gallstones formation, biliary sludge, pancreatitis
  • dyspepsia, nausea, vomiting, diarrhea, flatulence
  • xerostomia
  • elevated liver enzymes, hepatitis, jaundice

Musculoskeletal:

  • weakness, muscle spasms
  • arthralgia, tremors, numbness
  • elevated creatinine kinase 

Ocular:

  • visual disturbances, ocular burning

Renal:

  • oliguria, increased urine osmolarity
  • prostatitis
Drug Interactions:
  • oral cyclosporin + octreotide  = delayed and reduced absorption of cyclosporin
Monitoring Therapy:
  • heart rate
  • blood pressure
  • blood glucose
  • amylase, lipase, bilirubin, liver function tests
  • bowel function
  • skin
  • presence of hematemesis or melena
  • Hemoglobin
CCTC Protocol:
  • May be administered IV direct by a nurse in Adult Critical Care
  • IV direct by physician only
  • Continuous infusions must be administered by infusion device and the pump library must be enabled


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: October 11, 2018