Octreotide dosage

Population PK analysis following a single dose of 30 mg microencapsulated octreotide acetate intramuscularly the PK profile of microencapsulated octreotide acetate was effectively described by the derived population model. The relationship between IGF-1 and drug concentration could be used to guide optimization of therapeutic octreotide dosage regimens... 

Patients using octreotide may develop cholelithiasis or, with prolonged high dosages, hypothyroidism. 

Recommended dosage and monitoring requirements Sandostatin injectable solution is usually administered subcutaneously in initial doses of 50 to 100 pg two or three times daily. Upward dose titration is frequently required. Sandostatin LAR Depot injectable suspension should never be administered intravenously or subcutaneously. Patients not currently receiving octreotide acetate should begin therapy with subcutaneous injections and then can be switched to the depot injection of 20mg intragluteally at 4-week intervals for 3 months. 

In patients with severe renal failure requiring dialysis, the half-life of the octreotide may be increased, necessitating adjustment of the maintenance dosage. Octreotide acetate therapy is occasionally associated with mild transient hypo- or hyperglycemia due to alterations in the balance between the counterregulatory hormones insuhn, glucagon, and growth hormone. 

Octreotide decreases insulin resistance so that the dosage of insulin used by diabetics can be reduced. Fatal diabetic ketoacidosis... 

The interaction between insulin and octreotide is established and hypoglycaemia has been reported. If both drugs are used, anticipate the need to reduce the insulin dosage. The studies cited above suggest that about a 50% reduction is possible. 

The interaction between octreotide and ciclosporin is established and clinically important, although the documentation is limited. The authors of one report recommend that before giving octreotide the oral dosage of ciclosporin should be increased on average by 50% and the serum levels monitored daily. The manufacturers of lanreotide say that, as with other somatostatin analogues, it may reduce the absorption of ciclosporin from the gut. As yet there appear to be no reports of this interaction in practice however, it would be prudent to monitor the outcome of the use of lanreotide with ciclosporin. 

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