Octreotide - pharmacological drug that is derived from the hormone somatostatin, and used to treat diseases of the pancreas.
Structure and Composition
Octreotide is available as a solution for injection (in 1 ml ampoules). There are two doses - 50 and 100 mg (respectively 0, 0 and 005, 01% solution of the drug). Besides the active substance (octreotide) of the drug included sodium chloride and water. The solution is a clear, colorless, odorless liquid.
Available drug in a carton that contains 5 or 10 vials of Octreotide.
The pharmacological action of Octreotide
According to the instructions Octreotide is a derivative of the hormone somatostatin, and has similar effects, but the drug has a longer duration of action. Octreotide inhibits pathological increased secretion of growth hormone, as well as substances (serotonin, peptides) produced the diffuse endocrine system, gastrointestinal tract. The introduction of this drug is not accompanied by increased secretion of other hormones on the principle of "feedback".
Use of Octreotide in tumors of the digestive tract with hormonal activity (Vipom, gastrinoma, glucagonomas, insulinoma) to reduce specific symptoms (diarrhea, migrating rash, hypoglycemia, gastric ulceration), improve the quality of life of the patient, and prepare it for a possible operation.
According to reviews Octreotide has no negative impact on the course of diabetes.
Use of Octreotide in the early postoperative period after surgical interventions on hepatopancreatobiliary zone reduces the incidence of typical postoperative complications (postoperative pancreatitis, pancreatic fistula, abscess, sepsis, and others.).
After subcutaneous administration of Octreotide completely and rapidly absorbed, the maximum concentration in blood is determined after 30 minutes. The half-life of about 100 minutes. After intravenous administration, the maximum concentration of drug in the blood is almost immediately, the half-life is carried out in two phases (10 and 90 minutes).
- acute pancreatitis (in the fermentation phase);
- prevention and treatment of postoperative complications in patients undergoing surgery for abdominal organs;
- prevention or cessation of bleeding from esophageal varices and gastric cardia (in patients with portal hypertension);
- bleeding from ulcers of the stomach and duodenum;
- endocrine tumors of the digestive tract (Vipom, gastrinoma, glucagonomas, insulinoma, etc.).
Contraindications to the use of Octreotide
Hypersensitivity to octreotide.
Caution should be used Octreotide in patients with diabetes, cholelithiasis, as well as during pregnancy and lactation.
Use during pregnancy and lactation
Currently not carry out the necessary clinical trials on the use of Octreotide in pregnancy. In animal studies, the adverse effect of the drug on the fetus were observed. However, the use of Octreotide during pregnancy is possible only in the presence of absolute indications, where the benefits to the mother above the perceived risk to the fetus.
Side effects Octreotide
In the opinion of Octreotide rarely causes adverse reactions and generally well tolerated.
From the digestive system may cause anorexia, nausea, bloating, diarrhea, steatorrhea (fat excretion in feces). Long-term use of the drug may contribute to the formation of stones in the gallbladder.
Cardio - vascular system may occur very rarely arrhythmia, and bradycardia.
Feedback from local Octreotide rarely causes side effects include pain at the injection site, itching or burning sensation, swelling and redness at the injection site. Usually these events are themselves for 15 minutes.
Rarely allergic reactions can occur.
On the part of metabolism may occur following conditions: impaired glucose tolerance (due to suppression of insulin secretion), hypoglycemia.
Dosing and Administration
According to the instructions Octreotide is administered subcutaneously or intravenously.
In the treatment of acute pancreatitis (in the fermentation phase) recommended Octreotide subcutaneously administered 100 micrograms three times per day. The duration of treatment is 5 days. If necessary, the dose can be increased up to 1200 mg per day, and intravenous use. In the opinion of Octreotide has the best effect when administered in the first 2 days of illness.
To prevent postoperative complications recommended Octreotide 100 micrograms administered one hour prior to surgery and after surgery to 100 mg three times a day, the duration of treatment - 7 days.
In the treatment of bleeding esophageal varices and gastric cardia recommended administered intravenously at a dose of Octreotide 25-50 mcg / hour as a continuous infusion. Duration of therapy at least 5 days.
In the treatment of gastro-intestinal bleeding ulcer character Octreotide is recommended to apply a dose of 25 mg / hour by continuous intravenous infusion, the duration of administration - 5 days.
In case of overdose with this drug may develop the following symptoms - bradycardia, spastic abdominal pain, nausea, diarrhea, feeling a rush of blood to the face, a feeling of "emptiness" in the stomach.
Treatment is symptomatic.
Interaction with other drugs
If Octreotide is used in conjunction with diuretics, beta-blockers, calcium antagonists, insulin preparations, it may be necessary to adjust doses for these groups of drugs.
In the opinion of Octreotide causes less side effects, if its administration is between meals or at bedtime.
To prevent local reactions (in the form of pain at the injection site) is recommended to introduce the solution at room temperature. Also avoid prolonged administration of octreotide at the same place.
Patients with diabetes mellitus during treatment with octreotide may require dose adjustment of insulin (as this drug may reduce the need for insulin).