Cytoprotective and supportive care agents:
Indications for: SANDOSTATIN LAR DEPOT
Long-term treatment of severe diarrhea and flushing due to metastatic carcinoid tumors; and profuse watery diarrhea due to vasoactive intestinal peptide-secreting tumors in patients whom immediate-release (IR) octreotide acetate has been shown to be effective and tolerated.
Adult Dosage:
Give by intragluteal IM inj. Not currently receiving octreotide: initiate therapy with immediate-release octreotide SC inj for at least 2 weeks. Continue immediate-release octreotide therapy for ≥2 weeks, up to 3 or 4 weeks, after initial switch to LAR. Initially 20mg every 4 weeks for 2 months. After 2 months: if symptoms are controlled, may reduce to 10mg every 4 weeks; if symptoms are not controlled, may increase to max 30mg every 4 weeks. Dialysis or cirrhosis: initially 10mg every 4 weeks. Treat exacerbations with immediate-release octreotide SC inj at same dosage prior to switch.
Children Dosage:
Not recommended.
SANDOSTATIN LAR DEPOT Warnings/Precautions:
Diabetes. Hypothyroidism. Cardiovascular disease. Renal or hepatic impairment. Carcinoid tumors: monitor 5-HIAA, plasma serotonin, plasma Substance P. VIPomas: perform baseline and periodic total and/or free T4 measurements with chronic therapy. Monitor thyroid function, gallbladder, glucose, vitamin B12. Pregnancy. Nursing mothers.
See Also:
SANDOSTATIN LAR DEPOT Classification:
Somatostatin analogue.
SANDOSTATIN LAR DEPOT Interactions:
Potentiates bromocriptine, CYP450 substrates (eg, quinidine, terfenadine), bradycardia-inducing drugs (eg, β-blockers, calcium channel blockers). Antagonizes cyclosporine. Not compatible with TPN solutions. May need to adjust antidiabetic agents. May affect agents used to control fluid and electrolyte balance. May interfere with efficacy of lutetium Lu 177 dotatate inj; discontinue octreotide at least 24 hours prior to each lutetium Lu dose.
Adverse Reactions:
Gallbladder abnormalities (eg, gallstones, biliary sludge), GI upset, bradycardia, conduction abnormalities, arrhythmias, hyperglycemia, hypoglycemia, hypothyroidism, headache, dizziness, pancreatitis, back pain, inj site pain.
How Supplied:
Ampules 50mcg/mL, 100mcg/mL, 500mcg/mL (1mL)—10; LAR kit—1 (6mL vial w. supplies)
Pituitary disorders:
Indications for: SANDOSTATIN LAR DEPOT
Long-term maintenance therapy of acromegaly in patients who have had an inadequate response or cannot be treated with surgery and/or radiotherapy and in whom immediate-release (IR) octreotide acetate is effective and tolerated.
Adult Dosage:
Give by intragluteal IM inj. Not currently receiving octreotide: initiate therapy with immediate-release octreotide SC inj for at least 2 weeks. Switching from octreotide IR: initially 20mg every 4 weeks for 3months. After 3months, adjust as follows: GH≤2.5ng/mL, IGF-1 normal and clinical symptoms controlled: maintain dosage at 20mg every 4 weeks; GH≤1ng/mL, IGF-1 normal and clinical symptoms controlled: reduce to 10mg every 4 weeks; GH>2.5ng/mL, IGF-1 elevated and/or clinical symptoms uncontrolled: increase to 30mg every 4 weeks; may increase to max 40mg every 4 weeks. Pituitary irradiation recipients: withdraw therapy for 8 weeks once yearly to assess disease activity; resume if GH or IGF-1 levels increase or signs/symptoms recur.
Children Dosage:
Not recommended.
SANDOSTATIN LAR DEPOT Warnings/Precautions:
Diabetes. Hypothyroidism. Cardiovascular disease. Renal or hepatic impairment. Monitor growth hormone, IGF-1 levels, thyroid function, gallbladder, glucose, vitamin B12. Discontinue and treat if cholelithiasis complications are suspected. Pregnancy. Nursing mothers.
See Also:
SANDOSTATIN LAR DEPOT Classification:
Somatostatin analogue.
SANDOSTATIN LAR DEPOT Interactions:
Potentiates bromocriptine, CYP450 substrates (eg, quinidine, terfenadine), bradycardia-inducing drugs (eg, β-blockers, calcium channel blockers). Antagonizes cyclosporine. Not compatible with TPN solutions. May need to adjust antidiabetic agents. May affect agents used to control fluid and electrolyte balance. May interfere with efficacy of lutetium Lu 177 dotatate inj; discontinue octreotide at least 24 hours prior to each lutetium Lu dose.
Adverse Reactions:
Gallbladder abnormalities (eg, gallstones, biliary sludge), GI upset, bradycardia, conduction abnormalities, arrhythmias, hyperglycemia, hypoglycemia, hypothyroidism, headache, dizziness, pancreatitis, back pain, inj site pain.
How Supplied:
Ampules 50mcg/mL, 100mcg/mL, 500mcg/mL (1mL)—10; LAR kit—1 (6mL vial w. supplies)
