CV: edema, QT interval prolongation, atrioventricular block, bradycardia, hypertension, orthostatic hypotension, palpitations.
Derm: ↑ sweating, flushing.
EENT: sinusitis, visual disturbances.
Endo: hyperglycemia, hypoglycemia, hypothyroidism.
GI: abdominal pain, cholelithiasis, diarrhea, nausea, vomiting, cholecystitis, fat malabsorption, flatulence, ILEUS, PANCREATITIS.
GU: urinary tract infection.
Local: injection-site pain.
MS: arthralgia.
Neuro: headache, dizziness, drowsiness, fatigue, weakness.
Misc: ↓ vitamin B12 levels.
Carcinoid Tumors
- SC, IV (Adults): 100–600 mcg/day in 2–4 divided doses during first 2 wk of therapy (range 50–1500 mcg/day).
- IM (Adults): Sandostatin LAR: 20 mg every 4 wk for 2 mo; dose may be further adjusted.
VIPomas
- SC, IV (Adults): 200–300 mcg/day in 2–4 divided doses during first 2 wk of therapy (range 150–750 mcg/day).
- IM (Adults): Sandostatin LAR: 20 mg every 2 wk for 2 mo; dose may be further adjusted.
Acromegaly
- SC, IV (Adults): 50–100 mcg 3 times daily; titrate to achieve growth hormone levels <5 ng/mL or IGF-1 levels <1.9 units/mL (males) or <2.2 units/mL (females) (usual effective dose = 100–200 mcg 3 times daily).
- IM (Adults): Sandostatin LAR: 20 mg every 4 wk for 3 mo, then adjusted on the basis of growth hormone levels.
- PO (Adults): 20 mg twice daily initially; titrate based on IGF-1 levels obtained every 2 wk by 20 mg/day. If maintenance dose = 60 mg/day, administer as 40 mg in am and 20 mg in pm; if maintenance dose = 80 mg/day, administer as 40 mg twice daily (not to exceed 80 mg/day).
Renal Impairment
- PO (Adults): End-stage renal disease: 20 mg once daily initially; titrate based on IGF-1 levels obtained every 2 wk by 20 mg/day. If maintenance dose = 40 mg/day, administer as 20 mg twice daily; if maintenance dose = 60 mg/day, administer as 40 mg in am and 20 mg in pm; if maintenance dose = 80 mg/day, administer as 40 mg twice daily (not to exceed 80 mg/day).
Diarrhea Associated With Chemotherapy (off-label)
- SC, IV (Adults): 100–150 mcg SUBQ every 8 hr; may ↑ to 500–1500 mcg SUBQ or IV every 8 hr for severe diarrhea.
- SC (Children): 1–10 mcg/kg every 8–12 hr.
Diarrhea Associated With Graft-Versus-Host Disease (off-label)
- IV (Adults): 500 mcg every 8 hr; do not continue for longer than 7 days (discontinue within 24 hr of diarrhea resolution).
- SC (Children): 1–10 mcg/kg every 8–12 hr.
Gastroesophageal Variceal Hemorrhage (off-label)
- IV (Adults): 25–100 mcg bolus (may repeat in 1st hr if hemorrhage uncontrolled), followed by continuous infusion of 25–50 mcg/hr for 2–5 days.
- IV (Children): 1–2 mcg/kg bolus, followed by continuous infusion of 1–2 mcg/kg/hr; taper dose by 50% every 12 hr when no active bleeding for 24 hr; discontinue when dose is 25% of initial dose.
Mycapssa, SandoSTATIN, SandoSTATIN LAR Depot
Therapeutic Classification: antidiarrheals, hormones
Absorption: IV administration results in complete bioavailability. Well absorbed following SUBQ administration and IM administration of depot form. Food reduces rate and extent of oral absorption.
Distribution: Some distribution to extravascular tissues.
Metabolism/Excretion: Extensive hepatic metabolism; 32% excreted unchanged in urine.
Half-life: 1.5 hr.
