Sandostatin Lar Injection
Octreotide
20mg (large dose)
Novartis (Bangladesh) Ltd.
| Pack size | 20mg vial,1's pack |
|---|---|
| Unite Price | 82157.90 BDT |
Indications
Sandostatin Lar Injection is used for:
Acromegaly, Variceal haemorrhage, Secretory neoplasms, Following pancreatic surgery, HIV-associated diarrhoea
Adult Dose
Acromegaly
Solution: 50 mcg SC q8hr initially; titrate up to 500 mcg SC q8hr if necessary; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
Suspension (depot injection): 20 mg IM (gluteal) every 4 weeks for 3 months; titrate up or down to 10-30 mg IM every 4 weeks, depending on response; not to exceed 40 mg, as follows
Symptoms controlled: If GH < 1 ng/mL and IGF-1 normal, decrease dose to 10 mg IM every 4 weeks; if GH < 2.5 ng/mL and IGF-1 normal, maintain dose at 20 mg IM every 4 weeks
Symptoms uncontrolled: If GH > 2.5 ng/mL or IGF-I elevated, increase dose to 30 mg IM every 4 weeks; if symptoms persist, increase to 40 mg IM
Carcinoid Tumor
Solution: 100-600 mcg/day SC divided q6-12hr; may titrate to 1500 mcg/day; after successful treatment with solution for 2 weeks, initiate treatment with suspension (depot injection)
Suspension (depot injection): 20 mg IM every 4 weeks if regular injection well tolerated
Subcutaneous
Prophylaxis of complications following pancreatic surgery
Adult: 100 mcg tid of a rapid-acting preparation given for 7 consecutive days, starting at least 1 hr before operation.
HIV-associated diarrhoea
Adult: Initial dose 100 mcg tid. If symptoms are not controlled after 1 wk, increase dose to 500 mcg tid.
Intravenous
Variceal haemorrhage in patients with cirrhosis
Adult: As continuous IV infusion: 25 mcg/hr for 48 hr (up to 5 days in patients at high risk of re-bleeding).
Hepatic impairment: Cirrhosis, 10 mg IM every 4 weeks initially, then titrate to effect
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment: Without dialysis, dose adjustment not necessary; with dialysis, 10 mg IM every 4 weeks initially, then titrate to effect
Administration
IV Preparation
Common diluent: 50-100 ?g/50 mL NS
Common diluent for continuous IV infusion: 1200 ?g/250 mL NS
Minimum volume: 50 mL NS
IV/IM Administration
IM
Administer suspension (depot injection) immediately after reconstitution; inject into gluteal muscle, avoiding deltoid
IV
IV administration may be IVP, IVPB, or continuous infusion
Regular injection only: IVP should be administered undiluted over 3 minutes
IVPB: Administer over 15-30 minutes
Continuous infusion: 25-50 ?g/hr for treatment of esophageal variceal bleeding
Contra Indications
Hypersensitivity.
Precautions
Renal disease; risk of gall bladder disease; DM; hypothyroidism. Pregnancy, lactation, children, elderly. Monitor levels of vitamin B12 during long term therapy.
Lactation: Whether octreotide crosses into breast milk is not known; avoid giving to lactating women
Pregnancy-Lactation
Interactions
Dosage adjustment of concurrent therapy may be necessary with calcium channel blockers, oral hypoglycaemics, ?-blockers, diuretics. May increase concentration of bromocriptine.
Potentially Fatal: Requirements of insulin may be reduced requiring careful blood-glucose monitoring. Reduction in ciclosporin bioavailability and efficacy.
Side Effects
Side effects of Octreotide :
>10%
Gallbladder problems (>60%): Decreased gallbladder contractility, gallstones, cholecystitis, cholestatic hepatitis, Dysglycemia (25%), Hypothyroidism (25%), Bradycardia (25%)
1-10%
ECG changes (10%), Arrhythmia (9%), Pancreatitis, Upper respiratory tract infection, Fatigue, Headache, Malaise, Rash, Diarrhea, Nausea, Vomiting, Pain at injection site, Joint pain, Blurred vision
Mode of Action
Octreotide is a synthetic analogue of somatostatin which acts by suppressing basal and stimulated secretion of growth hormone (GH). It also suppresses LH response to gonadotrophin-releasing hormone and reduces the secretion of gastrin, vasoactive intestinal peptide (VIP), insulin, glucagon, secretin, motilin and pancreatic polypeptide.
Note
Sandostatin Lar 20mg (large dose) Injection generic name is Octreotide. Sandostatin Lar 20mg (large dose) Injection is manufactured by Novartis (Bangladesh) Ltd.Sandostatin Lar is availble in all over Bangladesh.
Mes BD drug index information on Sandostatin Lar Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.