Octreotide adverse effects

Use of the first-generation somatostatin analog octreotide is limited by its extremely short duration of action and requirement for subcutaneous administration at least three times a day. If a patient s GH level returns to baseline before the end of an 8-hour dosing interval, the frequency of octreotide administration can be increased to every 4 to 6 hours. Most patients require octreotide in doses of 100 to 200 meg three times daily.19,20 To improve patient tolerance to gastrointestinal (GI) adverse effects, start octreotide at 50 meg every 8 hours.20 Assess IGF-I serum concentrations every 2 weeks after initiating therapy to further titrate dose in increments of 50 meg per dose. 

Vasoactive drug therapy (somatostatin, octreotide, or terlipressin) to stop or slow bleeding is routinely employed early in patient management to allow stabilization of the patient and to permit endoscopy to proceed under more favorable conditions. These agents decrease splanchnic blood flow and reduce portal and variceal pressures, without significant adverse effects. 

Adverse effect of octreotide include nausea, vomiting, abdominal cramps and steatorrhea. 

Adverse effects of octreotide therapy include nausea, vomiting, abdominal cramps, flatulence, and steatorrhea with bulky bowel movements. Biliary sludge and gallstones may occur after 6 months of use in 20-30% of patients. However, the yearly incidence of symptomatic gallstones is about 1%. Cardiac effects include sinus bradycardia (25%) and conduction disturbances (10%). Pain at the site of injection is common, especially with the long-acting octreotide suspension. Vitamin B12 deficiency may occur with long-term use of octreotide. 

Octreotide, an octapeptide somatostatin analogue, is usually given subcutaneously in three divided doses per day. Longer-acting analogues, such as lanreotide, with similar efficacy and adverse effects to octreotide, but which can be given every 14-28 days, have been developed (1,2). The therapeutic indications and adverse effects of octreotide have been reviewed (SEDA-13,1309 3). 

A review of octreotide LAR has suggested that the most common adverse effects are gastrointestinal effects and injection site reactions (4). Injection site pain is also common and dose related. The cardiovascular, biliary, and glucose metabolism effects were also reviewed. 

Sinus bradycardia (less than 50/minute) is reported in up to 25% of acromegalic patients taking octreotide, and conduction abnormalities are also commonly reported in these patients. This adverse effect is reported only rarely in other recipients of somatostatin or octreotide, probably reflecting the high rate of cardiac abnormalities due to acromegaly (9). 

Although vasopressin and its analogues have been used in the acute management of bleeding esophageal varices, they do not reduce mortality (2,3) and the rate of adverse effects is higher than with octreotide (3). 

Originally isolated from the hypothalamus, somatostatin is a small polypeptide that is also found in neurons throughout the body, as well as in the intestine and pancreas. Somatostatin therefore predictably has a number of actions. Octreotide [awk TREE oh tide] is a synthetic octapeptide analog of somatostatin. It has a much longer half-life than the natural compound and has found use in the treatment of acromegaly caused by hormone-secreting tumors, and secretory diarrhea associated with tumors producing the vasoactive intestinal peptide (VIP). Adverse effects of octreotide treatment are flatulence, nausea, and steatorrhea. 

The most common adverse effects of octreotide therapy are gastrointestinal disturbances such as diarrhea, nausea, abdominal cramps, malabsorption of fat, and flatulence.xhese effects are dose dependent and can be seen within a few hours of the first octreotide injection. Gastrointestinal adverse effects occur in approx-... 

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