Can Octreotide Cause Drug Fever?
Octreotide is not recognized as a cause of drug fever in the medical literature or clinical guidelines. Drug fever is not listed among the known adverse effects of octreotide, and no documented cases exist linking this medication to fever as a hypersensitivity reaction 1.
Known Adverse Effect Profile of Octreotide
The well-established adverse effects of octreotide are primarily gastrointestinal and metabolic, not febrile 1, 2:
Gastrointestinal effects (most common): Diarrhea, loose stools, abdominal discomfort, nausea, and flatulence occur in up to 50% of patients but typically resolve within 3 months of treatment 3, 4
Metabolic disturbances: Both hypoglycemia and hyperglycemia can occur, requiring insulin dose adjustments in diabetic patients 1
Cardiac effects: Bradycardia and cardiac conduction abnormalities are reported 1
Gallbladder complications: Gallstones, sludge, and sediment develop in approximately 23.5% of patients during long-term therapy, though most remain asymptomatic 3, 4
Injection site reactions: Pain at subcutaneous injection sites is common 2
Rare Hematologic Adverse Effects (Not Fever)
While octreotide has been associated with rare hematologic abnormalities, these do not include fever 5:
Neutropenia: One case report documented octreotide-associated neutropenia with rapid resolution upon drug discontinuation, but no fever was reported 5
Hepatotoxicity: Acute hepatocellular liver injury has been documented in one rechallenge-confirmed case, but this presents as elevated transaminases rather than fever 6
Clinical Context for Fever in Octreotide-Treated Patients
If fever develops in a patient receiving octreotide, alternative etiologies should be investigated 1:
Underlying disease processes: Patients receiving octreotide often have neuroendocrine tumors, carcinoid syndrome, or cirrhosis—conditions that can independently cause fever 1
Infectious complications: Sepsis, spontaneous bacterial peritonitis, or other infections are common in critically ill patients receiving octreotide 1
Other medications: Many patients on octreotide receive multiple concurrent medications that are more likely culprits for drug fever 1
Drug Fever Characteristics (For Comparison)
True drug fever typically presents with specific features not associated with octreotide 1:
- Mean lag time of 21 days (median 8 days) between drug initiation and fever onset 1
- Fever resolution within 1-7 days after drug discontinuation 1
- Rash and eosinophilia are uncommon in drug fever 1
- Temporal relationship is key to diagnosis 1
Given the extensive clinical experience with octreotide over decades and the absence of any documented cases of drug fever, this medication should not be considered a cause of fever in clinical practice.