sandostatin lar: what is it, how to use, side effects

how does this medication work? what will it do for me?

octreotide is a man-made (synthetic) version of a naturally occurring hormone known as somatostatin. octreotide is used to treat severe diarrhea, flushing, and other symptoms that occur with certain cancers of the intestine. it works by slowing down the release of substances that cause diarrhea and flushing and by increasing water absorption.

octreotide also reduces the amount of growth hormone in the body, and so it is also used to treat acromegaly, a condition associated with overgrowth of the hands, feet, and parts of the face.

octreotide is also used for emergency treatment of certain causes of bleeding in the esophagus and stomach, and to prevent complications after pancreas surgery.

this medication may be available under multiple brand names and/or in several different forms. any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. as well, some forms of this medication may not be used for all of the conditions discussed here.

your doctor may have suggested this medication for conditions other than those listed in these drug information articles. if you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. do not stop using this medication without consulting your doctor.

do not give this medication to anyone else, even if they have the same symptoms as you do. it can be harmful for people to use this medication if their doctor has not prescribed it.

what form(s) does this medication come in?

each kit contains 1 single dose vial of octreotide (as acetate) slow release 10 mg, 20 mg, or 30 mg; 1 glass prefilled syringe containing 2.5 ml of diluent; one 19g×1.5 inch (40 mm) standard needle for transfer and drug product reconstitution, one 19g×1.5 inch (38.1 mm) safety injection needle; and an instruction booklet. nonmedicinal ingredients: mannitol and poly (dl-lactide-co-glycolide); diluent: mannitol, sodium carboxymethylcellulose, and water for injection.

how should i use this medication?

the recommended dose and dosing schedule of octreotide varies according to the specific condition being treated, the response to therapy, and the other medications or treatments being used. short-acting octreotide is injected under the skin (subcutaneous) of the hip, thigh, or abdomen 2 to 4 times daily. long-lasting octreotide is injected by a health care professional into the gluteal muscle (the buttocks) every 4 weeks. when used to treat bleeding in the esophagus and stomach, octreotide is given intravenously (into a vein).

many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. if your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

if you are giving yourself injections, it is important to use this medication exactly as prescribed by your doctor and to follow the instructions included with the medication very carefully. do not use this medication if it is discoloured or there are particles floating in it.

if you miss a dose of the short-acting medication, use it as soon as possible and continue with your regular schedule. if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. do not inject a double dose to make up for a missed one. if you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

octreotide can cause a number of side effects. your doctor, nurse, or pharmacist can advise you on how to reduce the effects of nausea and vomiting. keep track of any side effects and report them to your doctor, as suggested in the section "what side effects are possible with this medication?"

for prolonged storage, the short-acting form of this medication is stored in the refrigerator in its original carton (to protect it from light) and kept out of the reach of children. for day-to-day use, store this medication at room temperature for up to 2 weeks and protect it from light.

the long-acting form of this medication is stored in the refrigerator in its original carton (to protect it from light) but can be kept at room temperature on the day it is injected.

do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. ask your pharmacist how to dispose of medications that are no longer needed or have expired.

who should not take this medication?

octreotide should not be used by anyone who is allergic to octreotide or to any of the ingredients of the medication.

what side effects are possible with this medication?

many medications can cause side effects. a side effect is an unwanted response to a medication when it is taken in normal doses. side effects can be mild or severe, temporary or permanent.

the side effects listed below are not experienced by everyone who takes this medication. if you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

the following side effects have been reported by at least 1% of people taking this medication. many of these side effects can be managed, and some may go away on their own over time.

contact your doctor if you experience these side effects and they are severe or bothersome. your pharmacist may be able to advise you on managing side effects.

• bloating
• change in stool colour
• constipation
• diarrhea
• dizziness
• fatigue
• fatty stools
• gas
• hair loss
• headache
• loose stools
• loss of appetite
• nausea
• redness, bruising, or swelling at site of injection
• stomach discomfort
• vomiting

although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

check with your doctor as soon as possible if any of the following side effects occur:

• irregular heartbeat or slow heartbeat
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• signs of liver inflammation (e.g., yellowing of the skin and eyes, nausea, vomiting, loss of appetite, itching and pale stools)
• signs of gallstones (e.g., severe upper right abdominal pain, back pain, nausea and vomiting)
• signs of high blood sugar (e.g., excessive thirst, excessive urination, tingling or numbness in the hands or feet, headache, unusual tiredness or weakness)
• signs of low blood sugar (e.g., tiredness, fatigue, shakiness, headache, difficulty concentrating, hunger, blurred vision)
• signs of underactive thyroid gland (e.g., decreased heart rate, decreased appetite, weight gain, feeling cold, swelling at the front of the neck)

stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a severe allergic reaction (e.g., hives; shortness of breath; difficulty breathing; or swelling of the face, lips, tongue, or throat)
• signs of inflammation of the pancreas (e.g., severe abdominal pain)

some people may experience side effects other than those listed. check with your doctor if you notice any symptom that worries you while you are taking this medication.

are there any other precautions or warnings for this medication?

before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. these factors may affect how you should use this medication.

blood sugar levels: octreotide can cause high or low blood sugar. your doctor will monitor your blood sugar levels closely while you are using this medication, especially when you start treatment or when the dose is changed. if you experience symptoms of low blood sugar (e.g., tiredness, fatigue, shakiness, headache, difficulty concentrating, hunger, blurred vision) or high blood sugar (e.g., excessive thirst, excessive urination, weight loss) contact your doctor. people with diabetes should monitor their blood sugar regularly while using this medication and report any changes in blood sugar control to their doctor.

gallbladder problems: octreotide may cause gallbladder problems including gallstones. your doctor will periodically monitor for this with an ultrasound. if you have had gallstones, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

heart effects: in rare cases, this medication may cause abnormal heart rhythms or changes in your heart function. if you experience shortness of breath or a slow or irregular heartbeat, contact your doctor immediately. if you have any heart conditions, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

kidney function: kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. if you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

liver function: liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. if you have liver problems, including cirrhosis of the liver, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

nutritional issues: this medication may decrease the amount of fats and vitamin b12 that are absorbed by your body. your doctor will monitor for these effects with stool and blood tests.

thyroid problems: this medication may cause hypothyroidism (low thyroid). your doctor will monitor you for this with blood tests. if you experience symptoms of low thyroid (e.g., weight gain, tiredness, slow heart rate, feeling cold, or dry skin, swelling at the front of the neck), contact your doctor. if you have a thyroid condition, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

pregnancy: this medication should not be used during pregnancy unless the potential benefits outweigh the risks. tell your doctor immediately if you become pregnant while using this medication. women using this medication to treat acromegaly may be more likely to become pregnant. talk to your doctor about whether you need to use birth control while using this medication.

breast-feeding: it is not known if octreotide passes into breast milk. if you are a breast-feeding mother and are taking this medication, it may affect your baby. it is recommended that women not breast-feed while using this medication.

children: information regarding the use of octreotide for children is limited, although it is used mostly for children with a condition called hyperinsulinism (too much insulin in the body). long-term use of octreotide for children can affect their growth.

what other drugs could interact with this medication?

there may be an interaction between octreotide and any of the following:

• acetylsalicylic acid (asa)
• amiodarone
• androgens (e.g., testosterone)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• bromocriptine
• ceritinib
• chloroquine
• citalopram
• cyclosporine
• diabetes medications (e.g., glyburide, insulin, linagliptin, metformin, repaglinide, rosiglitazone, saxagliptin)
• digoxin
• diltiazem
• disopyramide
• dofetilide
• domperidone
• donepezil
• dronedarone
• fingolimod
• flecainide
• galantamine
• guanfacine
• indacaterol
• lacosamide
• lanreotide
• lopinavir
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• methadone
• methyldopa
• mifepristone
• monoamine oxidase inhibitors (maois; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
• pasireotide
• pegvisomant
• pentamidine
• procainamide
• propafenone
• protein kinase inhibitors (e.g., crizotinib, nilotinib, sunitinib)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
• rivastigmine
• saquinavir
• selective serotonin reuptake inhibitors (ssris; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
• sotalol
• tetrabenazine
• tizanidine
• verapamil

if you are taking any of these medications, speak with your doctor or pharmacist. depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

an interaction between two medications does not always mean that you must stop taking one of them. speak to your doctor about how any drug interactions are being managed or should be managed.

medications other than those listed above may interact with this medication. tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. also tell them about any supplements you take. since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

all material copyright mediresource inc. 1996 – 2023. terms and conditions of use. the contents herein are for informational purposes only. always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. source: www.medbroadcast.com/drug/getdrug/sandostatin-lar