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Octreotide

Classification

Somatostatin analog

Indications

CCP: Esophageal variceal bleeding

Contraindications

Hypersensitivity

Caution

Biliary disease
Growth hormone secreting tumours
Diabetes Mellitus
Thyroid disease
Cardiac disease
Hepatic impairment
Renal impairment
Premenopausal anovulatory patients
Cholelithiasis
May prolong QTc

Adult dosages

CCP: Esophageal variceal bleeding

Loading dose 25-100 mcg bolus IV
Maintenance 25-50 mcg/hr IV infusion

Pediatric Considerations And Dosing

CCP: Esophageal variceal bleeding

1 mcg/kg bolus IV
Maintenance 1 mcg/kg/hr (taper by 50% when no active bleeding for 24 hours)

Mechanism Of Action

Somatostatin analog that decreases splanchnic blood flow. It also decreases secretion of multiple hormones. These include GH, gastrin, VIP, LH, glucagon, insulin, secretin, serotonin, and pancreatic polypeptide.

Pharmacokinetics

Peak plasma time: IV immediate

Half-life: 1.7 hours

Adverse Effects

Coadministration with cyclosporine may decrease blood levels of cyclosporine and result in transplant rejection.
Octreotide inhibits the secretion of insulin and glucagon.
Coadministration with bromocriptine increases the availability of bromocriptine.
Patients on beta blocker, calcium channel blockers, or medications to control electrolyte balance may require dose adjustments of these agents.
Octreotide has been associated with alterations in nutrient absorption.

Warning And Precautions

Patients with established cirrhosis in the setting of hepatic impairment may necessitate a dosage adjustment.
Patients with renal failure receiving dialysis may require a dosage adjustment.
Fat absorption may be altered in some patients.
Octreotide may alter gallbladder function as such patients should be monitored for cholelithiasis.
May decrease vitamin B12.
Octreotide suppresses secretion of TSH as such patients should be monitored for hypothyroidism.
May enhance QTc prolonging agents.
Use cautiously in cardiac patients as rate and rhythm conduction abnormalities have been reported.
Somatostatin analogs may affect glucose regulation.
Elderly may need dose adjustments.
Females of childbearing age receiving octreotide may have a restoration of fertility.
Monitor patients receiving TPN as zinc levels may be affected.
May reduce excessive fluid loss in patients with conditions that cause fluid loss.

Drug Interactions

Disopyramide
Ibutilide
Indapamide
Pentamidine
Pimozide
Procainamide
Quinidine
Sotalol
Amiodarone
Amitriptyline
Amoxapine
Artemether
Chlorpromazine
Clarithromycin
Clomipramine
Desipramine
Dofetilide
Doxepine
Dronedarone
Droperidol
Epinephrine
Erythromycin
Fluconazole
Fluphenazine
Formoterol
Haloperidol
Hydrochloroquine sulfate
Imipramine
Ivosidenib
Ketoconazole
Lofepramine
Lumefantrine
Macimorelin
Maprotiline
Mefloquine
Moxifloxacin
Niloinib
Nortriptyline
Ondansetron
Perphenazine
Prochlorperazine
Promazine
Promethazine
Protriptyline
Ribociclib
Thioridazine
Trifluoperazine
Trimipramine
Umeclidinium bromide
Vandetanib
Vemurafenib
Vilanterol
Vilazodone
ziprasidone

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Licence Level Filtering

Octreotide

Classification

Indications

Contraindications

Adult dosages

Pediatric Considerations And Dosing

Mechanism Of Action

Pharmacokinetics

Adverse Effects

Warning And Precautions

Drug Interactions