Octreotide (Sandostatin LAR)

How does it work?

Sandostatin LAR injection contains the active ingredient octreotide, which is a type of medicine called a somatostatin analogue. It is similar to a naturally occurring hormone in the body called somatostatin. Somatostatin is produced in various parts of the body, including the brain, gut and pancreas. It prevents the release of other hormones found in the body, such as growth hormone and insulin.

Octreotide is used to relieve the symptoms of gastroenteropancreatic (GEP) tumours. Most tumours of this type develop in the organs of the digestive system. They usually start in the cells of the stomach (gastro), intestines (entero) and the pancreas. These areas of the body produce various hormones, and tumours that grow in these areas often cause too much of a certain hormone to be produced. The type of hormone overproduced depends on the type of gland that is affected by the tumour.

The different types of GEP tumours are named after cells where they develop. Insulinomas occur in the pancreas, causing excessive amounts of insulin to be produced. This can cause a fall in blood sugar level (hypoglycaemia). Glucagonomas also occur in the pancreas, but these cause excessive amounts of glucagon to be produced. Glucagon increases blood sugar and tumours of this type can cause symptoms of diabetes.

Gastrinomas occur in the stomach, causing excessive amounts of gastrin to be produced. Gastrin causes the production of stomach acid. If too much gastric acid is produced this can lead to ulcers in the stomach, oesophagus and small intestine. VIPomas usually occur in the pancreas and produce too much of a substance called vasoactive intestinal peptide (VIP). This can cause watery diarrhoea.

Carcinoid tumours are usually found in the intestines. They can produce excessive amounts of the hormone serotonin. The serotonin causes various symptoms, including diarrhoea, that together are known as carcinoid syndrome.

Octreotide mimics the action of natural sandostatin and so decreases the production of these types of hormones. Octreotide only relieves the symptoms of these hormone-producing tumours, it does not cure the tumour.

Octreotide is also used to treat acromegaly, which is a condition characterised by enlarged facial features, hands and feet, that results from excessive production of growth hormone by a tumour in the pituitary gland. Octreotide decreases the production of the growth hormone and so treats the symptoms of the condition, however, again it does not cure the tumour.

For acromegaly, this medicine is used for short-term treatment prior to pituitary surgery. It can also be used for long-term treatment in those who are inadequately controlled by pituitary surgery or radiotherapy, in the interim period until radiotherapy becomes effective, or in people for whom surgery is inappropriate.

Sandostatin LAR is a long-acting depot injection of octreotide that is given into the muscle of the buttock (intragluteal) every four weeks. The site of the injection should be alternated between the left and right buttock.

What is it used for?

  • Relief of symptoms caused by hormone-producing tumours of the gut, liver and pancreas (gastroenteropancreatic tumours)
  • A condition called acromegaly that results from excessive production of growth hormone by a tumour in the pituitary gland. Characteristics of this condition include enlarged facial features, hands and feet.

Warning!

  • Sandostatin LAR should be stored in a fridge between 2oC and 8oC. Do not freeze. Protect from light.
  • People receiving long-term treatment with this medicine should have their thyroid function regularly monitored.
  • This medicine may cause gallstones. An ultrasound examination of the gall bladder is recommended before treatment is started and at regular 6 month intervals during treatment.

Use with caution in

  • Diabetes mellitus
  • Insulin producing tumour (insulinoma)

Not to be used in

  • Allergy to any ingredient

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • Experience with this medicine during pregnancy is very limited. It is not recommended for use during pregnancy, unless considered essential by your doctor. Seek medical advice from your doctor.
  • Experience with this medicine during breastfeeding is very limited. It is not recommended for use during breastfeeding, unless considered essential by your doctor. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Pain, swelling or rash at site of injection
  • Loss of appetite
  • Nausea and vomiting
  • Abdominal pain
  • Bloating
  • Diarrhoea
  • Reduced absorption of fat by the intestine resulting in fatty, pale and offensive smelling stools (steatorrhoea)
  • Gallstones
  • Allergic skin reactions
  • High blood glucose level (hyperglycaemia)
  • Low blood glucose level (hypoglycaemia)
  • Hair loss (alopecia)
  • Inflammation of the liver (hepatitis)
  • Inflammation of the pancreas (pancreatitis)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while having treatment with this one, to ensure that the combination is safe.

Octreotide can decrease the absorption of the immunosuppressant ciclosporin from the gut and so can make it less effective. The dose of ciclosporin may need to be increased.

People with diabetes who are treated with this medicine may need lower doses of insulin or antidiabetic tablets.

Other medicines containing the same active ingredient

Sandostatin