octreotide

Adult Dosing .

Dosage forms:  INJ (pre-filled syringe): 50 mcg per mL, 100 mcg per mL, 500 mcg per mL; INJ (vial): various

acromegaly

[100-500 mcg SC/IV tid]

Start: 50 mcg SC/IV tid; Info: titrate based on serum GH or IGF-1 levels and sx; doses >300 mcg/day rarely more effective; D/C x4wk q1y in pts w/ pituitary irradiation to assess disease activity, need for tx

carcinoid tumor symptoms

[50-1500 mcg/day SC/IV divided qd-qid]

Start: 100-600 mcg/day SC/IV divided bid-qid x2wk; Info: for pts w/ severe diarrhea or flushing; titrate based on sx response

VIPoma symptoms

[150-750 mcg/day SC/IV divided bid-qid]

Start: 200-300 mcg/day SC/IV divided bid-qid x2wk; Info: for pts w/ severe diarrhea; titrate based on sx response

carcinoid crisis, acute (off-label)

[50-500 mcg IV prn]

Max: 500 mcg/dose; 1500 mcg/day; Alt: 50 mcg/h IV infusion x8-24h

carcinoid crisis prophylaxis (off-label)

[250-500 mcg IV x1]

Info: give 1-2h preop

diarrhea, secretory (off-label)

[50-1500 mcg/day SC/IV divided qd-tid]

Start: 50 mcg SC/IV bid-tid, then may incr. by 100 mcg/dose q48h; Max: 500 mcg/dose up to 1500 mcg/day; Info: titrate based on response

esophageal varices (off-label)

[50 mcg/h IV x5 days]

Start: 50 mcg IV x1; Info: for acute variceal bleeding

sulfonylurea overdose (off-label)

[50-100 mcg SC/IV q6-12h prn]

renal dosing

[see below]

renal impairment: not defined, caution advised

HD: consider decr. usual dose, on dialysis days admin. after dialysis; consider supplement if next maint. dose not due right after dialysis; PD: not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised

Peds Dosing .

Dosage forms:  INJ (pre-filled syringe): 50 mcg per mL, 100 mcg per mL, 500 mcg per mL; INJ (vial): various

diarrhea (off-label)

[infants/children]

Dose: 1-10 mcg/kg/day SC/IV divided q12-24h, titrate by 0.3 mcg/kg/dose q3 days prn; Max: 500 mcg/dose; 1500 mcg/day

sulfonylurea overdose (off-label)

[1-2 mcg/kg/dose SC/IV q6-12h prn]

Max: 50 mcg/dose

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: consider adult renal dosing for guidance

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised