Sandostatin LAR Depot

Adult Dosing .

Dosage forms:  INJ

acromegaly

[10-40 mg IM q4wk]

Start: 20 mg IM q4wk x3mo after pt stable on SC form; Max: 40 mg q4wk; Info: titrate in 10 mg intervals q3mo based on serum GH or IGF-1 levels and sx; D/C x8wk q1y in pts w/ pituitary irradiation to assess disease activity, need for tx

carcinoid tumor symptoms

[10-30 mg IM q4wk]

Start: 20 mg IM q4wk x2mo after pt stable on SC form; Max: 30 mg IM q4wk; Info: for pts w/ severe diarrhea or flushing; overlap SC tx for 2-4wk; titrate in 10 mg intervals q2mo based on sx; may use 10 mg IM q4wk if sx controlled at that dose; may augment w/ SC form for a few days periodically prn for sx exacerbation

VIPoma symptoms

[10-30 mg IM q4wk]

Start: 20 mg IM q4wk x2mo after pt stable on SC form; Max: 30 mg IM q4wk; Info: for pts w/ severe diarrhea; overlap SC tx for 2-4wk; titrate in 10 mg intervals q2mo based on sx; may use 10 mg IM q4wk if sx controlled at that dose; may augment w/ SC form for a few days periodically prn for sx exacerbation

gastroenteropancreatic neuroendocrine tumor (off-label)

[30 mg IM q4wk]

Start: 30 mg IM q8wk x4 doses, then 30 mg IM q4wk for up to 18mo total; Info: for somatostatin receptor-positive dz; use w/ lutetium Lu 177 dotatate for 1st 4 doses; give 4-24h after each lutetium Lu 177 dotatate dose, do not give w/in 4wk of each subsequent lutetium Lu 177 dotatate dose

renal dosing

[see below]

renal impairment: no adjustment

HD: start 10 mg q4wk; supplement after dialysis not defined; PD: start 10 mg q4wk; supplement not defined

hepatic dosing

[see below]

hepatic impairment: not defined, caution advised; cirrhosis: start 10 mg q4wk

Peds Dosing .

Peds dosing is currently unavailable or not applicable for this drug.