Octreotide

Octreotide (Sandostatin) — Somatostatin Analog

Evidence & Status

  • FDA Approved
  • Strong Human Evidence
  • Strong

At a Glance

A long-acting synthetic somatostatin analogue used in FDA-approved treatment of acromegaly and symptomatic hormone excess from carcinoid tumors and VIPomas. It also has extensive research and off-label use across neuroendocrine and gastrointestinal medicine.

Plain English

Octreotide mimics somatostatin, a natural hormone that acts like a brake on the release of several other hormones. Its longer duration makes that biology clinically useful. It can suppress excess growth hormone in acromegaly and reduce hormone-driven symptoms such as severe flushing and diarrhea from certain neuroendocrine tumors.

Overview

Octreotide is a synthetic cyclic octapeptide analogue of somatostatin with a substantially longer duration of action than the endogenous hormone. It suppresses secretion of growth hormone and several gastrointestinal and pancreatic hormones. FDA-approved uses include acromegaly and symptomatic control of hormone secretion from metastatic carcinoid tumors and VIPomas. Long-acting depot formulations allow chronic therapy at multi-week dosing intervals.

Research Summary

Octreotide has established product-specific uses in the Sandostatin Injection and Sandostatin LAR Depot labels. The PROMID randomized trial and NCT00171873 apply specifically to octreotide LAR in metastatic well-differentiated midgut neuroendocrine tumors; they do not establish effects for immediate-release octreotide, other formulations, or all indications. Immediate-release and LAR claims, including dosing and administration, remain formulation-specific.

Research Areas

  • Acromegaly
  • Carcinoid tumors
  • VIPoma
  • Neuroendocrine tumors

Safety & Risks

Serious Risks

  • Octreotide can reduce gallbladder contractility and bile secretion, leading to gallstones or biliary sludge; complications such as cholecystitis, cholangitis, and pancreatitis have been reported
  • Octreotide can alter insulin, glucagon, and growth-hormone regulation and may cause either hyperglycemia or hypoglycemia
  • Bradycardia, conduction abnormalities, and other ECG changes have been reported; patients with relevant cardiac disease or interacting medications may require monitoring
  • Octreotide can suppress thyroid-stimulating hormone and may lead to hypothyroidism during prolonged therapy
  • Reduced pancreatic enzyme and bile secretion can contribute to fat malabsorption and nutritional deficiencies during long-term treatment

Reported Side Effects

  • Abdominal pain or cramping
  • Nausea
  • Diarrhea or loose stools
  • Injection site reactions
  • Headache
  • Gallbladder sludge or gallstones
  • Hyperglycemia or hypoglycemia
  • Bradycardia
United States
Sandostatin Injection and Sandostatin LAR Depot have separate U.S. labels, indications, and dosing; formulation-specific claims must remain product-specific.
United Kingdom
Product- and jurisdiction-specific.
Australia
Product- and jurisdiction-specific.
Canada
Product- and jurisdiction-specific.

Citations & Sources