In the article, we consider the instructions for use for the drug "Octreotide".
The medication is an analogue of somatostatin, has a synthetic origin. Somatostatin is a natural hormone, and a drug based on its artificial analogue has identical properties, but a longer lasting effect. "Octreotide" inhibits the production of growth hormone in cases where it is overestimated or caused by exposure to arginine, insulin-type hypoglycemia or physical exertion.
Structure
According to the instructions, "Octreotide" is made in the form of a solution for injection, both subcutaneously and intravenously. In 1 ml of solution contains 50 or 100 μg of the active component of octreotide. The contents of one ampoule can be diluted with water for injection or sodium chloride, depending on the route of administration. One package contains 5 ampoules of a solution of 1 ml.
As indicated by the instructions for use, "Octreotide" 20 mg and 30 mg is a drug of prolonged action, lyophilisate for the preparation of a suspension. It is called Octreotide Long.
Indications for use
The drug is intended for treatment in the field of gastroenterology. The main indication for using the drug is acromegaly, which is a violation of the pituitary gland. "Octreotide" allows you to control the symptomatic manifestations of pathology and reduce the level of growth hormone and IGF-1 in the plasma. The drug may be required in cases where there is no positive dynamics during radiation therapy and surgery.
In addition, in accordance with the instructions, "Octreotide" for pancreatitis is also prescribed.
The drug is prescribed to patients who, with a diagnosis of acromegaly, refused to perform the operation or have contraindications to its implementation. "Octreotide" is also suitable for a short course of treatment in between radiation therapy until the effect of its conduct.
"Octreotide" according to the instructions is also used to control the manifestations of endocrine neoplasms in the gastrointestinal tract and pancreas of the secreting type, such as:
- Vipomas.
- Carcinoid type tumors with concomitant carcinoid syndrome.
- Glucagonomas.
- Insulinomas. The use of the drug provides for the control of hypoglycemia in the period before the operation, as well as supporting treatment.
- Zollinger-Ellison disease, gastrinomas. The drug is used simultaneously with proton pump inhibitors and H2-histamine receptor blockers.
- Somatoliberinomas. They are neoplasms accompanied by hyper production of growth hormone releasing factor .
It should be borne in mind that "Octreotide" is not a means for treating a tumor, it does not cure cancer. It only helps control concomitant tumor symptoms.
Another area of application of the drug is the elimination of bleeding and the prevention of hemorrhagic syndrome in varicose veins of the esophagus and stomach in patients with a diagnosis of cirrhosis. Most often, Octreotide is prescribed in combination with various therapeutic procedures, such as endoscopic sclerotherapy.
Instruction manual
"Octreotide" can be administered either subcutaneously or intravenously. The dosage regimen and duration of use depends on the indications and goals for which the drug is used:
- The relief of hemorrhagic ulcer type syndrome is 25-50 micrograms per hour intravenously for a five-day course.
- The relief of hemorrhagic syndrome in the veins of the esophagus and stomach, dilated with varicose veins, is 25-50 micrograms per hour intravenously for a five-day course.
- According to the instructions for use, “Octreotide” for acute pancreatitis is prescribed in the amount of 100 mcg subcutaneously three times a day with a five-day course. In some cases, a specialist may prescribe an intravenous administration of the drug up to 1200 mcg per day.
- Prevention of complications after surgery on the pancreas is 100-200 mcg subcutaneously. Before laparotomy, the first dosage is administered in 1-2 hours, after the operation - three times a day for 5-7 days.
- Tumors of the gastroenteropancreatic endocrine system - at the initial stage of treatment, 50 μg subcutaneously up to two times a day with the possibility of a gradual increase in dosage to 100-200 μg three times a day.
- Acromegaly - 50-100 mcg subcutaneously 2-3 times a day.
With prolonged treatment with "Octreotide", it is necessary to monitor growth hormone indicators twice a year. In case of liver dysfunction, adjustment of the therapeutic dose of the drug may be required.
Contraindications and adverse reactions
Absolute contraindications for the use of "Octreotide", according to the instructions, are:
- Patient under the age of 18 years.
- Hypersensitivity to octreotide.
With caution, the drug is prescribed in the following conditions:
- Cholelithiasis or gallstone disease.
- Diabetes.
- The period of bearing a child.
- Lactation.
The introduction of "Octreotide" can provoke the development of the following side effects:
- An allergic reaction, accompanied by a rash, itching, urticaria, etc.
- Metabolic process: impaired glucose tolerance, hypoglycemia.
- Heart and blood vessels: arrhythmia, bradycardia.
- Adverse reactions of a local nature: burning and itching, soreness, swelling and redness at the injection site. Such symptoms disappear on their own some time after the procedure of administration of the drug.
- Digestive system: anorexia, diarrhea, nausea, excrement with feces of fat, flatulence.
With prolonged use of the drug, the formation of calculi in the gallbladder may be observed.
Overdose
In medical practice, cases of overdose with Octreotide have been reported. Against the background of accidental administration to the patient of a drug at a dosage of 2400-6000 μg intravenously or 1500 μg subcutaneously, the following symptoms were observed:
- Arrhythmia.
- Low blood pressure in the arteries.
- Sudden cardiac arrest.
- Pancreatitis
- Hypoxia of the brain.
- The degeneration of the liver.
- Weakness.
- Diarrhea.
- Weight loss.
- Inhibition.
- Lactic acidosis.
- Hepatomegaly.
When the drug was accidentally administered to a child at a dosage of 50-3000 μg intravenously or 50-100 μg subcutaneous hyperglycemia of a moderate degree of intensity occurred.
With the introduction of 3000-30000 μg per day, divided into three times, patients with tumors of new adverse reactions were not followed.
Combination with other drugs
Dosage adjustment will be required with the simultaneous use of octreotide with the following groups of drugs:
- Glucagon.
- Hypoglycemic drugs.
- Insulin.
- Inhibitors of calcium channels.
- Diuretics.
- Beta blockers.
In addition, when prescribing "Octreotide", it should be borne in mind that the active component of the drug has the following effect:
- Reduces the absorption of cyclosporine.
- Increases the bioavailability of bromocriptine.
- Slows down the absorption process of cimetidine.
- Reduces the metabolism of terfenadine and quinidine.
The listed features should be considered before starting to use the drug, since a lack of attention to these rules can lead to undesirable consequences for the patient's condition.
Analogs
In the instructions for use, analogues of "Octreotide" are not indicated.
The modern pharmaceutical market is ready to offer several drugs based on octreotide:
- Octrid.
- Sandostatin. Presented in the form of a powder for solution preparation. The drug can be administered either subcutaneously or intravenously.
- "Octretex."
- "Somatostatin." It is made on the basis of a pure substance. The drug inhibits the synthesis of growth hormone and serotonin, as well as some types of peptides.
- "Octreotide FSynthesis."
- "Sermorelin." It is prescribed during diagnostic measures to determine the functions and reactivity of growth hormones.
- "Diferelin". It is produced on the basis of tryptorelin acetate and is intended for administration in the form of subcutaneous injections. It is prescribed in the treatment of infertility in women, as well as before IVF in order to inhibit certain hormones for successful conception.
Replacing any drug even with its synonym requires consultation with your doctor. This will help to avoid negative reactions from the body.
Reviews
Quite a few reviews can be found on the Internet at Oktreotid. Basically, comments are written by patients who were prescribed the drug for acute pancreatitis. In this case, there are no complaints about Octreotide; it effectively eliminates the symptoms of pancreatitis and relieves pain. The only drawback of the drug is its high cost, which averages 1,500 rubles per package.
Not all experts consider the effectiveness of "Octreotide" unconditionally proven. Even when prescribed for the treatment of pancreatitis, many doctors say that monotherapy in this case is not enough, especially when it comes to an acute form of pathology. It is also suggested that immediately before surgery, a simple cleansing of the stomach by washing or fasting may be required.
As a rule, "Octreotide" is prescribed in cases where other drugs have not given the proper result. At the same time, patients and doctors note that with a repeated course of treatment with the drug, its effectiveness is significantly reduced. It is believed that this is the result of sensitization and an increased risk of developing adverse reactions, such as nausea.
Conclusion
Thus, "Octreotide" is acceptable in the treatment of pancreatitis. In some cases, the drug really relieves the exacerbation and alleviates the symptoms of the disease. It is important to conduct therapy under strict medical supervision. Only in this way will it be possible to achieve the necessary results and prevent complications.
We reviewed the drug "Octreotide" instructions for use and reviews.