What is Octreotide (somatostatin analogue) drip used for?

From the Guidelines

Octreotide drip is primarily used to prevent carcinoid crisis in patients with carcinoid syndrome undergoing major surgery or hepatic artery embolization, and to manage secretory diarrhea associated with carcinoid tumors, VIPomas, and other neuroendocrine tumors. The use of octreotide drip is supported by guidelines for the management of gastroenteropancreatic neuroendocrine tumors, which recommend prophylactic administration of somatostatin analogues to prevent carcinoid crisis in patients with carcinoid syndrome undergoing major surgery or hepatic artery embolization 1. Some key points to consider when using octreotide drip include:

• Typical dosing for preventing carcinoid crisis is 50 mg per hour, initiated 12 hours before and given for 24-48 hours after surgical intervention 1
• Octreotide works by mimicking natural somatostatin, which inhibits the release of various hormones including glucagon, insulin, gastrin, and vasoactive intestinal peptide
• Patients receiving octreotide should be monitored for potential side effects including hyperglycemia, hypoglycemia, cardiac conduction abnormalities, and gallbladder sludging or stones with prolonged use
• The most recent and highest quality study on this topic is from 2012, which provides guidance on the use of octreotide drip in patients with carcinoid syndrome 1. Other studies have also investigated the use of octreotide in managing symptoms of carcinoid syndrome, including secretory diarrhea, and have found it to be effective in reducing symptoms and improving quality of life 1. However, the 2012 study provides the most specific guidance on the use of octreotide drip in preventing carcinoid crisis, and is therefore the most relevant to this question.

From the FDA Drug Label

Octreotide acetate injection exerts pharmacologic actions similar to the natural hormone, somatostatin. It is an even more potent inhibitor of growth hormone (GH), glucagon, and insulin than somatostatin Like somatostatin, it also suppresses luteinizing hormone (LH) response to gonadotropin releasing hormone (GnRH), decreases splanchnic blood flow, and inhibits release of serotonin, gastrin, vasoactive intestinal peptide (VIP), secretin, motilin, and pancreatic polypeptide By virtue of these pharmacological actions, octreotide has been used to treat the symptoms associated with metastatic carcinoid tumors (flushing and diarrhea), and VIP secreting adenomas (watery diarrhea).

The Octreotide drip is used for:

• Treating symptoms associated with metastatic carcinoid tumors (flushing and diarrhea)
• Treating symptoms associated with VIP secreting adenomas (watery diarrhea)
• Reducing growth hormone (GH) and/or insulin growth factor-1 (IGF-1) levels in patients with acromegaly 2

From the Research

Octreotide Drip Uses

• Octreotide drip, a somatostatin analogue, is used to treat various conditions, including:
  • Carcinoid syndrome: Octreotide has been shown to be effective in controlling symptoms such as flushing, diarrhea, and abdominal pain in patients with carcinoid syndrome 3.
  • Acromegaly: Octreotide is used to treat acromegaly, a condition characterized by excessive growth hormone production, by reducing growth hormone levels and alleviating symptoms such as headache, joint pain, and carpal tunnel syndrome 4, 5, 6.
• The medication works by mimicking the action of somatostatin, a natural hormone that regulates various bodily functions, including growth hormone production and gastrointestinal secretions.

Administration and Dosage

• Octreotide drip is typically administered subcutaneously or intravenously, with the dosage and frequency of administration varying depending on the specific condition being treated and the patient's response to therapy.
• In patients with carcinoid syndrome, octreotide is often started at a dose of 100 micrograms subcutaneously three times a day, with the dose titrated upward as needed to control symptoms 3.
• In patients with acromegaly, octreotide is often administered at a dose of 20-30 mg intramuscularly every 4 weeks, with the dose adjusted based on the patient's growth hormone levels and clinical response 4, 5, 6.

Efficacy and Safety

• Octreotide drip has been shown to be effective in controlling symptoms and reducing growth hormone levels in patients with acromegaly and carcinoid syndrome 3, 4, 5, 6.
• Common side effects of octreotide drip include gastrointestinal symptoms such as diarrhea, nausea, and abdominal pain, as well as injection site reactions and hyperglycemia 4, 6, 7.