Warnings and Precautions Gallbladder abnormalities may occur. There have been postmarketing reports of cholelithiasis (gallstones) resulting in complications, including cholecystitis, cholangitis, ...
Expert Opinion Interview
In this case-based conversation, Sandy Kotiah, MD, and Eric Liu, MD, FACS, discuss key symptoms of carcinoid syndrome, biomarker testing, differential diagnosis, and treatment with Sandostatin LAR Depot.
Treatment With Sandostatin LAR Depot
Oncology Nurse Elizabeth Cruz discusses treatment with Sandostatin® LAR Depot (octreotide acetate) for injectable suspension, including tips for mixing and administration, clinical data and safety information, and Novartis resources for patients.
From Discovery to Symptom Control
Explore the history that led to the world’s first SSA* approved by the FDA for the severe diarrhea and flushing associated with metastatic carcinoid tumors. Take a look back at the years of research that led to the FDA approval of Sandostatin LAR Depot to reduce the severe diarrhea and flushing associated with metastatic carcinoid tumors.
FDA, US Food and Drug Administration; LAR, long-acting release; SSA, somatostatin analogue.
*Includes Sandostatin® (octreotide acetate) Immediate-Release Injection and Sandostatin LAR Depot for all approved indications.
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. Antidiabetic 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 ECG 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 (TPN) and octreotide should have periodic monitoring of zinc levels
- 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
- The most common adverse reactions occurring in patients receiving Sandostatin LAR Depot were 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.