For:
Severe Diarrhea and Flushing Associated With Carcinoid Syndrome
Important Safety Information

Warnings and Precautions Gallbladder abnormalities may occur. There have been postmarketing reports of cholelithiasis (gallstones) resulting in complications, including cholecystitis, cholangitis, ...

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Indication Sandostatin® LAR Depot (octreotide acetate) for injectable suspension is indicated for long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors and long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors in patients in whom initial treatment with immediate-release Sandostatin® (octreotide acetate) Injection has been shown to be effective and tolerated. In patients with carcinoid syndrome and VIPomas, the effect of Sandostatin Injection and Sandostatin LAR Depot on tumor size, rate of growth, and development of metastases has not been determined.

On-Demand Training & Resources

 

Whether you are first learning or just in need of a refresher, these training modules can help you navigate treatment with Sandostatin® LAR Depot (octreotide acetate) for injectable suspension. The training modules below include videos and downloadable resources that cover mixing and administration, as well as management of the symptoms of severe diarrhea and flushing of carcinoid syndrome.

How to Mix

Learn how to mix Sandostatin LAR Depot and become more comfortable with the reconstitution process. After viewing this video, be sure to watch the next video module below, “How to Administer.”

 

Downloadable resources for mixing:

How to Administer

Learn the administration process for Sandostatin LAR Depot, including some tips for ensuring a proper injection. Before administering, be sure to watch the “How to Mix” video above.

 

Downloadable resources for administration:

How to Administer Dorsogluteal and Ventrogluteal Injections

Learn how to administer dorsogluteal and ventrogluteal injections with Sandostatin LAR Depot. This video will show you how to prepare your patient for injection, provide steps to locate the dorsogluteal and ventrogluteal injection sites, and offer intramuscular injection tips. Before administering, be sure to watch the “How to Mix” and “How to Administer” videos above.

IMPORTANT SAFETY INFORMATION

Warnings and Precautions

  • Gallbladder abnormalities may occur. There have been postmarketing reports of cholelithiasis (gallstones) resulting in complications, including cholecystitis, cholangitis, pancreatitis, and requiring cholecystectomy in patients taking Sandostatin® LAR Depot (octreotide acetate) for injectable suspension. Patients should be monitored periodically. If complications of cholelithiasis are suspected, discontinue Sandostatin LAR Depot and treat appropriately
  • Glucose Metabolism: Hypoglycemia or hyperglycemia may occur. Blood glucose levels should be monitored when Sandostatin LAR Depot treatment is initiated or when the dose is altered. Anti-diabetic treatment should be adjusted accordingly
  • Thyroid Function: Hypothyroidism may occur. Baseline and periodic assessment of thyroid function (TSH, total and/or free T4) is recommended
  • Cardiac Function: Bradycardia, arrhythmia, conduction abnormalities, and other electrocardiogram changes may occur. The relationship of these events to octreotide acetate is not established because many of these patients have underlying cardiac disease. Use with caution in at-risk patients
  • Nutrition: Octreotide may alter absorption of dietary fats. Monitoring of vitamin B12 levels is recommended during therapy with Sandostatin LAR Depot. Patients on total parenteral nutrition and octreotide should have periodic monitoring of zinc levels

Drug Interactions

  • The following drugs require monitoring and possible dose adjustment when used with Sandostatin LAR Depot: cyclosporine, insulin, oral hypoglycemic agents, beta-blockers, and bromocriptine. Octreotide has been associated with alterations in nutrient absorption, so it may have an effect on absorption of orally administered drugs. Drugs mainly metabolized by CYP3A4 and which have a low therapeutic index should be used with caution
  • Octreotide competitively binds to somatostatin receptors and may interfere with the efficacy of lutetium Lu 177 dotatate. Discontinue Sandostatin LAR Depot at least 4 weeks prior to each lutetium Lu 177 dotatate dose

Adverse Reactions

  • The most common adverse reactions occurring in patients receiving Sandostatin LAR Depot are biliary abnormalities (62%), injection-site pain (20%-50%), nausea (24%-41%), abdominal pain (10%-35%), fatigue (8%-32%), headache (16%-30%), hyperglycemia (27%), back pain (8%-27%), constipation or vomiting (15%-21%), dizziness (18%-20%), sinus bradycardia (19%), pruritus (18%), upper respiratory tract infection (10%-18%), myalgia (4%-18%), flatulence (9%-16%), arthropathy (8%-15%), rash (15%), generalized pain (4%-15%), sinusitis (5%-12%), conduction abnormalities (9%), hypoglycemia (4%), and arrhythmia (3%)

Please see full Prescribing Information on this website.

Indications and Usage

Sandostatin® LAR Depot (octreotide acetate) for injectable suspension is indicated for patients in whom initial treatment with immediate-release Sandostatin® (octreotide acetate) Injection has been shown to be effective and tolerated for

  • Long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors
  • Long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors

 

In patients with carcinoid syndrome and VIPomas, the effect of Sandostatin Injection and Sandostatin LAR Depot on tumor size, rate of growth, and development of metastases has not been determined.

 

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Downloadable resources for dorsogluteal and ventrogluteal injections:

Clinical Considerations

Learn how you can help patients by identifying potential triggers of carcinoid syndrome, providing dietary tips, tips to avoid flare-ups, and additional monitoring considerations.

 

Downloadable resources for clinical considerations for the triggers of carcinoid syndrome:

Dosing

For information about flexible dosing options and titration, visit the Dosing & Administration page

Additional Resources

Here are some additional downloadable resources you may find useful:

For more information on the Sandostatin LAR Depot Co-pay Program, visit the Access page.

For more information on patient support programs, visit the Patient Resources page.

IMPORTANT SAFETY INFORMATION

Warnings and Precautions

  • Gallbladder abnormalities may occur. There have been postmarketing reports of cholelithiasis (gallstones) resulting in complications, including cholecystitis, cholangitis, pancreatitis, and requiring cholecystectomy in patients taking Sandostatin LAR Depot. Patients should be monitored periodically. If complications of cholelithiasis are suspected, discontinue Sandostatin LAR Depot and treat appropriately
  • Glucose Metabolism: Hypoglycemia or hyperglycemia may occur. Blood glucose levels should be monitored when Sandostatin LAR Depot treatment is initiated or when the dose is altered. Anti-diabetic treatment should be adjusted accordingly
  • Thyroid Function: Hypothyroidism may occur. Baseline and periodic assessment of thyroid function (TSH, total and/or free T4) is recommended
  • Cardiac Function: Bradycardia, arrhythmia, conduction abnormalities, and other electrocardiogram changes may occur. The relationship of these events to octreotide acetate is not established because many of these patients have underlying cardiac disease. Use with caution in at-risk patients
  • Nutrition: Octreotide may alter absorption of dietary fats. Monitoring of vitamin B12 levels is recommended during therapy with Sandostatin LAR Depot. Patients on total parenteral nutrition and octreotide should have periodic monitoring of zinc levels

Drug Interactions

  • The following drugs require monitoring and possible dose adjustment when used with Sandostatin LAR Depot: cyclosporine, insulin, oral hypoglycemic agents, beta-blockers, and bromocriptine. Octreotide has been associated with alterations in nutrient absorption, so it may have an effect on absorption of orally administered drugs. Drugs mainly metabolized by CYP3A4 and which have a low therapeutic index should be used with caution
  • Octreotide competitively binds to somatostatin receptors and may interfere with the efficacy of lutetium Lu 177 dotatate. Discontinue Sandostatin LAR Depot at least 4 weeks prior to each lutetium Lu 177 dotatate dose

Adverse Reactions

  • The most common adverse reactions occurring in patients receiving Sandostatin LAR Depot are biliary abnormalities (62%), injection-site pain (20%-50%), nausea (24%-41%), abdominal pain (10%-35%), fatigue (8%-32%), headache (16%-30%), hyperglycemia (27%), back pain (8%-27%), constipation or vomiting (15%-21%), dizziness (18%-20%), sinus bradycardia (19%), pruritus (18%), upper respiratory tract infection (10%-18%), myalgia (4%-18%), flatulence (9%-16%), arthropathy (8%-15%), rash (15%), generalized pain (4%-15%), sinusitis (5%-12%), conduction abnormalities (9%), hypoglycemia (4%), and arrhythmia (3%)

Please see full Prescribing Information.

Indications and Usage

Sandostatin® LAR Depot (octreotide acetate) for injectable suspension is indicated for patients in whom initial treatment with immediate-release Sandostatin® (octreotide acetate) Injection has been shown to be effective and tolerated for

  • Long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors
  • Long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors

In patients with carcinoid syndrome and VIPomas, the effect of Sandostatin Injection and Sandostatin LAR Depot on tumor size, rate of growth, and development of metastases has not been determined.