Sandostatin

Generic name: Octreotide
Other trade name: Sandostatin LAR®
Other name: Octreotide Acetate

Drug Type:

Sandostatin is a hormone drug that is used to treat some types of cancer.  Sandostatin is classified as a somatostatin analog.  (For more detail, see "How Sandostatin Works" section below).

What Sandostatin Is Used For:

• Sandostatin is given to control symptoms such as diarrhea or flushing in patients with tumors such as carcinoid, pancreatic islet cell tumors, gastrinoma, or vasoactive intestinal peptide-secreting tumors (VIPomas).
• It is also used to treat acromegaly, when the body produces too much growth hormone, and the hands, feet, face or head grow too large.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Sandostatin Is Given:

• Sandostatin has two formulations.  For purposes of clarity, trade names will be used for discussion. Sandostatin is a short acting version and Sandostatin LAR is a long acting version.
• Sandostatin is given by subcutaneous injection (the layer of tissue between the skin and the muscle).  It may be necessary to take the shot several times a day.  The injection sites should be rotated regularly.  Sandostatin may also be given intravenously.
• Sandostatin LAR is given by intramuscular injection (into the muscle) under a doctor's supervision.  Sandostatin is generally given once every 4 weeks.  The preferred site for injection is the hip, because it is painful given into the arm.  Sandostatin LAR should NOT be given by S.C. or IV routes.
• If short acting Sandostatin is to be replaced by long-acting Sandostatin LAR, short acting Sandostatin should be continued for at least two weeks to maintain therapeutic doses in patients with carcinoid tumors or VIPomas. 
• Short acting Sandostatin may also be used to control breakthrough symptoms in carcinoid. 
• The amount of Sandostatin that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose and schedule.

Side Effects:

Important things to remember about the side effects of Sandostatin:

• Most people do not experience all of the side effects listed.
• Side effects are often predictable in terms of their onset and duration. 
• Side effects are almost always reversible and will go away after treatment is complete.
• There are many options to help minimize or prevent side effects.
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
• The side effects of Sandostatin and their severity depend on how much of the drug is given and which preparation (Sandostatin or Sandostatin LAR) is given.  In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in greater than 30%) for patients taking Sandostatin:

• Gallstones (common with long term use but rarely symptomatic enough to require intervention)
• Nausea
• Pain at the injection site (especially with Sandostatin LAR)

These side effects are less common side effects (occurring in about 10-29%) of patients receiving Sandostatin:

• Abdominal Pain 
• Flatulence (gas) 
• Constipation
• Vomiting
• Diarrhea (may be due to the disease rather than the medication)
• Upper respiratory infection (see lung problems)
• Fatigue
• Flu-like syndrome
• Dizziness
• Headache
• If you have diabetes, your blood sugar levels may be affected. Discuss this with your healthcare provider, how you will monitor your blood sugar readings at home. 
• You may experience a slower heartbeat

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

The following symptoms require medical attention, but are not an emergency.  Contact your health care provider within 24 hours of noticing any of the following:

• Nausea (interferes with ability to eat and unrelieved with prescribed medication)
• Vomiting (vomiting more than 4-5 times in a 24 hour period)
• Diarrhea (4-6 episodes in a 24-hour period)
• Constipation unrelieved by laxative use

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting Sandostatin treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).   Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category B (there is no evidence of risk in humans based on negative animal studies.  Use in pregnancy only if clearly needed). For both men and women: Do not conceive a child (get pregnant) while taking Sandostatin. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking Sandostatin.

Self-Care Tips:

• Sandostatin is given to treat severe diarrhea. However, you may become constipated. If you do not move your bowels after 2 days, notify your healthcare provider. 
• You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to the drug is known.
• For flu-like symptoms, keep warm with blankets and drink plenty of liquids.  There are medications that can help reduce the discomfort caused by chills.
• Acetaminophen or ibuprofen may help relieve discomfort from fever, headache and/or generalized aches and pains.  However, be sure to talk with your doctor before taking it.
• Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals. 
• Avoid sun exposure.  Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely.  You should discuss this with your doctor.
• Get plenty of rest. 
• Maintain good nutrition.

If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

• Your health care provider will want to do blood tests to see how well you are responding to Sandostatin. Keep all appointments for tests, and office visits. 
• Your doctor may also monitor other types of blood work, to see if the medication is affecting other parts of your body.

How Sandostatin Works:

Sandostatin is similar to a natural chemical called somatostatin.  Somatostatin is produced in the body by the hypothalamus.  One of its functions is to "switch off" the secretion of growth hormone by the pituitary gland.  Somatostatin also decreases splanchnic blood flow and inhibits the release of serotonin, gastrin, vasoactive intestinal peptide, secretin, motilin and pancreatic polypeptide.  These actions are what helps to control the symptoms of flushing and diarrhea in carcinoid tumors and Vasoactive Intestinal Peptide (VIP) secreting adenomas.

Somatostatin is chemically unstable and broken down by the body within minutes of its release.  Sandostatin, in contrast, is very stable and, therefore, much longer acting.  It is for this reason that Sandostatin is preferred for medicinal use.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.  

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