Select a medication above to begin.
octreotide
generic
Adult Dosing .
Dosage forms: INJ (pre-filled syringe): 50 mcg per mL, 100 mcg per mL, 500 mcg per mL; INJ (vial): various
acromegaly
- [100-500 mcg SC/IV tid]
- Start: 50 mcg SC/IV tid; Info: titrate based on serum GH or IGF-1 levels and sx; doses >300 mcg/day rarely more effective; D/C x4wk q1y in pts w/ pituitary irradiation to assess disease activity, need for tx
carcinoid tumor symptoms
- [50-1500 mcg/day SC/IV divided qd-qid]
- Start: 100-600 mcg/day SC/IV divided bid-qid x2wk; Info: for pts w/ severe diarrhea or flushing; titrate based on sx response
VIPoma symptoms
- [150-750 mcg/day SC/IV divided bid-qid]
- Start: 200-300 mcg/day SC/IV divided bid-qid x2wk; Info: for pts w/ severe diarrhea; titrate based on sx response
carcinoid crisis, acute (off-label)
- [50-500 mcg IV prn]
- Max: 500 mcg/dose; 1500 mcg/day; Alt: 50 mcg/h IV infusion x8-24h
carcinoid crisis prophylaxis (off-label)
- [250-500 mcg IV x1]
- Info: give 1-2h preop
diarrhea, secretory (off-label)
- [50-1500 mcg/day SC/IV divided qd-tid]
- Start: 50 mcg SC/IV bid-tid, then may incr. by 100 mcg/dose q48h; Max: 500 mcg/dose up to 1500 mcg/day; Info: titrate based on response
esophageal varices (off-label)
- [50 mcg/h IV x5 days]
- Start: 50 mcg IV x1; Info: for acute variceal bleeding
sulfonylurea overdose (off-label)
- [50-100 mcg SC/IV q6-12h prn]
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD: consider decr. usual dose, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: INJ (pre-filled syringe): 50 mcg per mL, 100 mcg per mL, 500 mcg per mL; INJ (vial): various
diarrhea (off-label)
- [infants/children]
- Dose: 1-10 mcg/kg/day SC/IV divided q12-24h, titrate by 0.3 mcg/kg/dose q3 days prn; Max: 500 mcg/dose; 1500 mcg/day
sulfonylurea overdose (off-label)
- [1-2 mcg/kg/dose SC/IV q6-12h prn]
- Max: 50 mcg/dose
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- caution: biliary dz
- caution: tumor, GH-secreting
- caution: diabetes mellitus
- caution: thyroid dz
- caution: cardiac dz
- caution: hepatic impairment
- caution: renal impairment
Drug Interactions .
Overview
octreotide
somatostatin analog
- alters gallbladder contraction/motility
- bradycardia
- gastric pH sensitive
- hyperglycemic effects
- hypoglycemic effects
- caution advised w/ narrow therapeutic index drugs extensively metabolized by CYP450 liver enzymes; octreotide inhibition of growth hormone production may decr. CYP450 metabolic function, incr. levels of concomitant drugs, risk of adverse effects
- caution advised w/ oral drugs; octreotide alters nutrient absorption, may alter absorption of concomitant drugs, incr. risk of adverse effects or decr. efficacy
Avoid/Use Alternative
- brigatinib
- ceritinib
- crizotinib
- etrasimod
- fexinidazole
- fingolimod
- levonorgestrel (contraceptive)
- lofexidine
- ozanimod
- ponesimod
- siponimod
Monitor/Modify Tx
- acarbose
- acebutolol
- adenosine
- alectinib
- alfentanil
- alogliptin
- aluminum hydroxide
- amiloride
- amiodarone
- apraclonidine ophthalmic
- articaine
- atazanavir
- atenolol
- betaxolol
- betaxolol ophthalmic
- bexagliflozin
- bisoprolol
- bromocriptine
- bumetanide
- bupivacaine
- bupivacaine liposomal
- calcium carbonate
- canagliflozin
- carbamazepine
- carteolol ophthalmic
- carvedilol
- chloroprocaine
- chlorothiazide
- chlorthalidone
- cimetidine
- clonidine
- clozapine
- colesevelam
- corticotropin
- cyclosporine
- dapagliflozin
- dexlansoprazole
- dexmedetomidine
- dexmedetomidine injection
- digoxin
- diltiazem
- donepezil
- dronedarone
- dulaglutide
- empagliflozin
- ertugliflozin
- esmolol
- esomeprazole
- ethacrynic acid
- everolimus
- exenatide
- famotidine
- felodipine
- fentanyl
- furosemide
- galantamine
- glimepiride
- glipizide
- glyburide
- guanfacine
- ibutilide
- indapamide
- insulin
- isradipine
- ivabradine
- labetalol
- lacosamide
- lansoprazole
- lasmiditan
- levobunolol ophthalmic
- lidocaine
- linagliptin
- liraglutide
- lisinopril
- lopinavir/ritonavir
- lutetium Lu 177 dotatate
- magnesium carbonate
- magnesium hydroxide
- mannitol
- mefloquine
- mepivacaine
- metformin
- metolazone
- metoprolol
- midodrine
- nadolol
- nateglinide
- nebivolol
- neostigmine
- nimodipine
- nisoldipine
- nizatidine
- omeprazole
- pantoprazole
- pasireotide
- phenytoin
- pindolol
- pioglitazone
- pramlintide
- praziquantel
- propranolol
- pyridostigmine
- quinidine (antiarrhythmic)
- rabeprazole
- remimazolam
- repaglinide
- ritonavir
- rivastigmine
- ropivacaine
- rosiglitazone
- saxagliptin
- semaglutide
- sincalide
- sitagliptin
- sodium bicarbonate
- sodium zirconium cyclosilicate
- sotalol
- spironolactone
- sugammadex
- thalidomide
- ticagrelor
- timolol
- timolol ophthalmic
- tirzepatide
- torsemide
- triamterene
- verapamil
- vonoprazan
Adverse Reactions .
Serious Reactions
- cholecystitis
- cholelithiasis
- ascending cholangitis
- gallbladder sludge
- biliary obstruction
- cholestatic hepatitis
- pancreatitis
- GI obstruction
- diabetes mellitus
- bradycardia
- arrhythmia
- cardiac conduction disturbance
- AV block, complete (IV use)
- syncope
- edema, severe
- CHF exacerbation
- HTN
- anaphylaxis
- goiter (acromegaly use)
- hypothyroidism
- vitamin B12 deficiency
- zinc excess (TPN pts)
- thrombocytopenia
Common Reactions
- diarrhea
- abdominal pain
- flatulence
- biliary tract abnormalities
- cholelithiasis
- abdominal distension
- constipation
- nausea
- vomiting
- hyperglycemia
- hypothyroidism
- injection site pain
- headache
- anemia
- HTN
- dizziness
- fatigue
- weakness
- pruritus
- URI sx
- flu syndrome
- arthropathy
- hypoglycemia
- hematoma
- edema
- urinary frequency
- fat malabsorption
- alopecia
- visual disturbance
- depression
Safety/Monitoring .
Monitoring Parameters
TFTs at baseline, then periodically if chronic tx; vitamin B-12 levels; glucose; zinc if TPN tx; consider ECG if IV admin.
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; no known risk of teratogenicity based on animal data at 7x and 13x MRHD
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no known risk of infant harm based on limited human data and drug properties; inadequate human data available to assess effects on milk production
Pharmacology .
Metabolism: liver; CYP450: unknown
Excretion: urine (32% unchanged); Half-life: 1.7-1.9h, 2.5h (elderly), 2.4h (CrCl 40-60), 3.0-3.1h (CrCl <40), 3.4-3.7h (fatty liver dz, cirrhosis)
Subclass: Diarrhea ; Growth Hormone Antagonists ; Toxicity: Drugs
Mechanism of Action
inhibits multiple hormones including growth hormone, glucagon, insulin, LH, VIP, serotonin, gastrin, motilin, secretin, and pancreatic polypeptide; decreases splanchnic blood flow (somatostatin analog)
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: generic
DEA/FDA: Rx
Approximate Retail Price
from http://www.goodrx.com/octreotide
injectable solution:
- 50 mcg/mL (90 vial, 1 mL): $156.00
- 100 mcg/mL (90 vial, 1 mL): $220.00
- 500 mcg/mL (45 vial, 1 mL): $524.00
injectable solution:
- 200 mcg/mL (18 vial, 5 mL): $634.00
- 1,000 mcg/mL (2 vial, 5 mL): $203.00
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.