Octreotide

UK SPC for Octreotide 100 microgram/ml solution for injection/infusion (immediate-release). This id is the emergency-medicine entry and therefore leads with the acute indication in §4.2, bleeding gastro-oesophageal varices; the bundle's name field carries only the generic 'Octreotide'. The dose above is an HOURLY INFUSION RATE in micrograms/hour — it is not a bolus and not a subcutaneous dose. CIRRHOTIC PATIENTS: 'In cirrhotic patients with bleeding gastro-oesophageal varices, Octreotide has been well tolerated at continuous i.v. doses of up to 50 micrograms/hour for 5 days' — the §4.4 ceiling of 50 micrograms/hour still applies. HEPATIC IMPAIRMENT (directly relevant here, as most patients treated for variceal bleeding are cirrhotic): in patients with liver cirrhosis the half-life of the drug may be increased, necessitating adjustment of the maintenance dosage. OTHER LICENSED INDICATIONS: §4.2 also covers acromegaly, gastro-entero-pancreatic endocrine tumours, complications following pancreatic surgery and TSH-secreting pituitary adenomas — all SUBCUTANEOUS regimens in micrograms per injection, on a different route and a different unit basis from the infusion rate above. Their figures are deliberately NOT reproduced on this emergency page to avoid a subcutaneous dose being read as an infusion rate; see the general octreotide entry. PAEDIATRIC: 'Experience with Octreotide in children is limited' — the SPC states no paediatric dose, so none is recorded here; verify any under-18 use against a children's formulary. MONITORING (§4.4): patients on high-dose intravenous octreotide need appropriate cardiac monitoring; octreotide may affect glucose regulation (both hyperglycaemia and hypoglycaemia are reported); thyroid and hepatic function should be monitored during prolonged treatment, and gallbladder ultrasound is recommended before and at about 6- to 12-month intervals during longer-term therapy.