Description overdue on 02/05/2013

An analogue of the hormone somatotropin synthetic origin. The active substance has a similar pharmacological effect, long duration. The drug has antithyroid effect It reduces the hormone TSH and growth hormone, has antispasmodic effects. The drug can slow down the motility of the digestive tract, to reduce the production of gastric juice. Under the action of the drug inhibited hypersecretion of peptides , Growth hormone and serotonin which production is carried out in part of gastroenteritis-pancreatic endocrine system.

The drug reduces the production of growth hormone during insulin-induced hypoglycemia, the action of arginine under stress; reduces the secretion of gastrin, glucagon, insulin and other peptide gastroenteritis-pancreatic endocrine portion when eating; reduces the production of TSH by the action tireoliberina. The active ingredient of the drug inhibits the production of growth hormone expression than insulin. When administered medicament is not observed phenomenon hormonal hypersecretion type "negative feedback".

Patients with acromegaly Sandostatin reduces somatomedin A   and growth hormone in the blood plasma. Normalization of level of growth hormone on the background of of spent therapy is registered 50% of patients, as well CLINICAL SIGNIFICANCE decrease in the level of growth hormone is observed practically at 100% of patients. When treating patients with carcinoid tumors   marked reduction in the severity of symptoms: decreased levels of serotonin, a urine output of 5-HIAA, reduced frequency of diarrhea, " tides "Blood flow to the skin of the face.

When malignancy, for which is characteristic hypersecretion of VIP - vasoactive intestinalnogo peptide, on the background of of treatment octreotide   improving the quality of life of patients (reduced severe secretory diarrhea, normal electrolyte balance, allowing you to cancel the parenteral, enteral administration of fluids and electrolytes). In some cases observed not only deceleration, but and Stopping progression Development neoplasm, size reduction tumor, metastases in liver. By reducing the level of VIP marked clinical improvement. When diagnosed glucagonomas medication does not reduce the need for taking oral hypoglycemic agents and insulin, no significant impact on the course of diabetes, but significantly reduces the severity of necrotising migrans rash .

Patients who suffer from persistent diarrhea, octreotide causes it to decrease, which in turn leads to an increase in body weight, a rapid decrease in blood levels of glucagon. Prolonged application leads to a weakening of the effect described. For a considerable period of time, patients reported symptomatic improvement. Sandostatin administered in combination with proton pump inhibitors, H2 receptor blockers, causing reduction in the formation of hydrochloric acid in the stomach, reducing the severity of many symptoms, reduction of gastrin in the blood.

The medicament is capable of reducing the level of immunoreactive insulin in patients with insulinomas (effect may be short - about 2 hours). In patients with operable tumors, octreotide provides and supports normoglycemia   preoperatively. Patients diagnosed with rare tumors, which are characterized by overproduction of the hormone releasing factor growth, marked reduction in the severity of symptoms of acromegaly. This effect is due to the suppression of growth hormone and its releasing factor. In the future, says reducing the size of hypertrophic pituitary.

Sandostatin is capable of significantly reduce the severity of of such symptoms, as fatigue, paresthesia , Headache, rash, peripheral neuropathy , Pain in the joints, bones. In patients with pituitary adenomas, for which is characteristic secretion of of growth hormone, it is celebrated reduction of the sizes neoplasms. Sandostatin LAR is a dosage form of the drug long-acting, appointed 1 every 4 weeks, which allows for stable therapeutic concentration of the active substance in the body. The microspheres contain a polymer matrix comprising a main component. With the introduction intramuscular there is a slow, gradual release of of the active component at the expense of of destruction microspheres in the muscle tissue. Sandostatin issued in the form solution and powder.

Indications:

Instructions for use of the drug Sandostatin recommends that to appoint the medicament when of acromegaly (at an inefficiency of of therapy agonists dopamine, radiation therapy, to patients, who refused from of operative intervention, unresectable sick). The drug is prescribed for symptom relief at neoplasms gastroenteritis-pancreatic endocrine system department (gastrinoma, glucagonomas, carcinoid tumors   with carcinoid syndrome, tumors with hyper VIP) at somatoliberinomah, insulinoma , With persistent diarrhea in patients with AIDS. The drug is prescribed after surgery on the pancreas. Sandostatin recommended for application for the prevention and stop bleeding   of varicose veins of the esophagus.

Contraindications:

Medicament is contraindicated in in case of intolerance of octreotide. When breastfeeding, diabetes, cholelithiasis , Pregnancy Sandostatin administered with caution.

Side effect:

The treatment may be abdominal pain of spastic origin, nausea, eating disorders, stearrhea , Diarrhea, increased flatulence, increase of liver enzymes, the development of of acute pancreatitis, alopecia, acute hepatitis without the phenomena of cholestasis , Increased GGT hyperbilirubinemia . When long-term therapy there is a decrease in glucose tolerance, the development of reactive pancreatitis, cholelithiasis, hypoglycemia, hyperglycemia, persistent allergies. Perhaps a burning sensation, redness, tenderness and swelling of the skin at the injection site.

Overdose:

Display a sense of emptiness in the stomach, nausea, "tides" of blood flow to the face, a short-term slowing of the pulse, spastic abdominal pains . Treatment is carried out posindromnoe.

Mode of application:

Sandostatin injected subcutaneously, intramuscularly, intravenously. Initial dosage acromegaly is 0, 05-0, 1 mg subcutaneously interval between injections 8-12 hours. Further correction mode is carried out individually depending on the tolerability, the monthly changes in the level of growth hormone clinical studies. For the majority of patients prescribed daily dosage in the amount of 0, 2-0, 3 mg of octreotide. Inadmissible to excess maximum dose - 1, 5 mg / day. Treatment was stopped if within 3 months can not reach the desired level of growth hormone, if the patient does not feel better notes.

In endocrine tumors   the medicament is administered subcutaneously in an amount of 0, 05 mg 1-2 times a day. Further strategy depends on the rate of decline in growth hormone levels, hormone levels, which produces swelling. Patients with a diagnosis of "AIDS"   at persistent diarrhea   Sandostatin administered subcutaneously in an initial dosage 0, 1 mg three times a day. If diarrhea syndrome does not stop for a day, then a single dose of 0, 25 mg. If there is no further effect for a week octreotide therapy is stopped.

For warnings complications after operative interventions on the pancreas Sandostatin administered subcutaneously for 1 hour till laparotomy in a dose 0, 1 mg; After surgical preparation administered three times a day for 0, 1 mg, the course of therapy is designed for 7 days. To stop the bleeding from esophageal varices, octreotide is administered intravenously for 5 days, the infusion rate - 0, 025 mg / hr. Sandostatin LAR is administered intramuscularly, alternate injection sites. Patients with acromegaly drug is administered every 4 weeks at a dose of 20 mg, the treatment is designed for 3 months. Intramuscular injections may be performed immediately after a course of subcutaneous administration.

In the absence of positive dynamics within 3 months of a single dose of 30 mg (1 to 4 times a week). When the stabilization of the patient, sustained reduction in the level of growth hormone levels stabilize IFR1, disappearance of reversible signs of acromegaly dose of the drug is reduced to 10 mg. Determining the level and IFR1 serum concentration of growth hormone is conducted one time in 6 months at stable medication. In endocrine tumors of the gastrointestinal tract and pancreas Sandostatin LAR administered at a dose of 20 mg every 4 weeks. If drug treatment provides for 3 months normalization of biological markers of disease and adequate control of clinical symptoms, then the amount of medicament reduced to 10 mg (1 to 4 times a week).

Special instructions:

In the treatment of patients with gastroenteritis-pancreatic endocrine tumors occur rarely relapses. When diagnosed pituitary tumors require more careful monitoring of patients for early detection of tumor growth and contraction visual fields . Y patients diagnosed with insulinomas   marked increase in the severity and duration hypoglycemia . With the introduction of Sandostatin in between meals and at bedtime to reduce the severity of possible side effects from the digestive tract.

If long-term treatment of acromegaly necessarily an ultrasound state gallbladder   for early diagnosis of cholelithiasis. It is not recommended to inject at short intervals in the same area. A solution of octreotide prior to administration to warm to room temperature. Sandostatin when feeding-FEEDING and carrying of a pregnancy prescribe on absolute indications. With more frequent administration of small doses is avoided significant fluctuations of glucose. During treatment requires regular monitoring of blood sugar index. The drug should not be administered intravenously. Sandostatin LAR is administered by deep intramuscular injection (preferably gluteus maximus). In case of contact with a blood vessel requires the replacement of the needle and the injection zone.

Drug Interactions:

Sandostatin is able to slow down the rate of absorption cimetidine , Reduce the absorption cyclosporine . It requires a mandatory correction dosing regimen at simultaneous the treatment of glucagonomas, diuretic agents, insulin, beta-blockers , Hypoglycemic drugs. The drug is able to increase the bioavailability of the drug bromocriptine . According to some reports somatostatin analogues are capable of reducing the metabolism of drugs that are metabolized in the liver by an enzyme system in the   Cytochrome P450   (obsnyaetsya suppression of growth hormone). Therefore, drugs that have a narrow therapeutic dose range and using metabolized by cytochrome P450, administered with caution.