Octreotide

How it works

It mimics the action of somatostatin, inhibiting the release of several gut and pituitary hormones and reducing splanchnic and portal blood flow, which helps control variceal haemorrhage.

Prescribing in practice

• It can disturb glucose control, causing either hyperglycaemia or hypoglycaemia, so blood glucose should be monitored, particularly in people with diabetes.
• Long-term use predisposes to gallstones, so periodic gallbladder assessment is advised with prolonged therapy.
• It can slow the heart and cause bradycardia, warranting caution in those with cardiac conduction problems.

Monitoring

During acute use monitor blood glucose, heart rate and the clinical response to bleeding; with long-term therapy add periodic gallbladder imaging and thyroid and other relevant endocrine assessment as indicated.

Counselling the patient

• Report symptoms of high or low blood sugar, such as marked thirst, drowsiness, sweating or shakiness.
• Report abdominal pain, which may indicate gallstones with longer-term treatment.
• Report palpitations or feeling that the heart is beating slowly.

Evidence & guidelines

Used as an adjunct in the management of acute variceal bleeding and in selected neuroendocrine and secretory disorders.