Sandostatin

Sandostatin is a prescription medication used to treat the symptoms of acromegaly, carcinoid tumors, and vasoactive intestinal peptide adenomas. Sandostatin belongs to a class of drugs called octapeptides, which work by decreasing the amounts of certain natural substances. These substances may be made in excessive amounts by the body because of certain conditions like tumors.

Sandostatin is available in an injectable form to be given directly into a vein (IV) by a healthcare professional. It is also available in an injectable form to be given directly under the skin (subcutaneously) that may be done by the patient after proper training.

A long-acting form of Sandostatin is available in an injectable form to be given directly into a muscle (IM) by a healthcare professional.

The immediate-release injection (Sandostatin) is usually injected 2 to 4 times a day. The ong-acting injection (Sandostatin LAR Depot) is usually injected once every 4 weeks.

Common side effects of Sandostatin include bile duct abnormalities, fatigue, headache, and abdominal pain. Sandostatin can cause dizziness. Do not drive or operate heavy machinery until you know how Sandostatin affects you.

Sandostatin is a prescription medication used to treat symptoms of the following conditions:

• acromegaly. This is a condition in which the body makes too much growth hormone. This causes an enlargement of the hands, feet, and facial features. It can also lead to joint pain and other symptoms.
• carcinoid tumors. Carcinoid tumors are slow-growing tumors that release natural substances that can cause diarrhea and flushing.
• vasoactive intestinal peptide secreting adenomas (VIP-omas). These are tumors that form in the pancreas and release natural substances that can cause many negative symptoms including diarrhea.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Inject Sandostatin exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The Sandostatin dose your doctor recommends will be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended dose range for Sandostatin (octreotide) is 100 to 750 micrograms (mcg), divided into equal doses and taken 2 to 4 times daily.

The recommended dose for Sandostatin LAR Depot (long-acting octreotide) is 20 mg every four weeks for three months (for acromegaly) or for two months (for carcinoid tumors or VIP-omas). It should be used only after response and tolerance has been shown with Sandostatin.

Serious side effects have been reported with Sandostatin including:

• bile duct abnormalities. Tell your healthcare provider right away if you have any or all of the following symptoms of bile duct abnormality:
  • yellowing of the skin or eyes
  • itching
  • weight loss
  • a decreased appetite
  • fatigue
  • fever or night sweats
  • light brown urine
  • abdominal (stomach area) pain
  • clay-colored or greasy stools
• low or high blood sugars. Blood glucose levels should be monitored when Sandostatin is started or when the dose is changed. If you are on medication(s) for diabetes, your doses may be changed.
• hypothyroidism. Assessment of thyroid function is recommended. Tell your healthcare provider right away if you have any or all of the following symptoms of hypothyroidism:
  • fatigue
  • weight gain
  • feel cold
  • feel sluggish
  • dry skin
  • constipated
• heart irregularities. Bradycardia (a slow heart rate), arrhythmia (an irregular heart rate), conduction abnormalities, and other changes may occur. Use with caution if you have heart problems.
• nutritional imbalances. Sandostatin may change the absorption of dietary fats. Monitoring of vitamin B12 levels is recommended during therapy with Sandostatin. Those needing total parenteral nutrition (TPN) and Sandostatin should have periodic monitoring of zinc levels.

Sandostatin can cause dizziness. Do not drive or operate heavy machinery until you know how Sandostatin affects you.

Do not take Sandostatin if you are allergic to any of its ingredients.

Serious side effects have been reported with Sandostatin. See the “Drug Precautions” section.

Common side effects of Sandostatin include:

• bile duct abnormalities. Bile ducts are small tubes that carry bile between the liver and the gallbladder and from the gallbladder to the small intestine. Bile helps you digest food.
• fatigue
• headache
• abdominal (stomach area) pain
• diarrhea
• dizziness
• gallstones
• flatulence (gas)
• flu-like symptoms (fever, muscle aches, nausea, chills)
• constipation
• injection site pain
• vomiting

This is not a complete list of Sandostatin side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• insulin
• medications that treat high blood sugar such as glyburide (Micronase, Diabeta), pioglitazone (Actos), and metformin (Glucophage)
• beta blockers such as propranolol (Inderal), carvedilol (Coreg), metoprolol (Lopressor, Toprol XL), and nadolol (Corgard)
• bromocriptine (Parlodel)
• medications that use the enzyme CYP3A4 such as alfentanil (Alfenta), astemizole (Hismanal), cisapride (Propuslid) cyclosporine (Neoral, Gengraf, Sandimmune), dihydroergotamine (Migranal, DHE-45), ergotamine (Ergostat, Medihaler Ergotamine), fentanyl (Abstral, Actiq, Fentora, Onsolis), pimozide (Orap), quinidine (Quinact, Quinalan), sirolimus (Rapamune, Rapamycin), tacrolimus (Prograf)

This is not a complete list of Sandostatin drug interactions. Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Sandostatin falls into category B. There are no well-done studies that have been done in humans with Sandostatin. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known whether Sandostatin passes into human milk. Because many drugs can pass into human milk, caution should be used when Sandostatin is given to a nursing woman.

Octreotide can cause changes in blood glucose levels. Your doctor will need to monitor your blood glucose levels when octreotide is started or when the dose is changed. If you are on medication(s) for diabetes, your doses may be changed.

Talk to your doctor about where on your body you should inject the medication and how you should rotate injection spots so that you do not inject in the same spot too often.

Before you inject your medication, always look at the liquid and do not use it if it is cloudy or contains particles.

If you are being treated for a carcinoid tumor or VIP-oma, you may experience worsening of your symptoms from time to time during your treatment. If this happens, tell your doctor.

Octreotide injection may control your symptoms, but it will not cure your condition. Continue to use octreotide injection even if you feel well.