Usual Adult Dose for Carcinoid Tumor:
Initial dose: 100 to 600 mcg per day, IV or subcutaneously, in 2 to 4 divided doses
Comments:
-The median daily dose was 450 mcg; mean daily dose was 300 mcg.
-Benefits were seen in doses from 50 mcg to 1500 mcg per day.
-Experience with doses above 750 mcg per day is limited.
Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):
Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 2 months; continue with dose of regular octreotide for at least 2 weeks (at same dose patient was on before the switch)
After 2 months:
-If symptoms are controlled, consider reducing dose to 10 mg every 4 weeks
-If symptoms are not adequately controlled, increase to 30 mg every 4 weeks
Maximum dose: 30 mg every 4 weeks
Comments:
-Failure to continue dosing of regular octreotide during a switch to the long acting formulation may exacerbate symptoms; some patients require 3 to 4 weeks of concomitant dosing.
Use: Symptomatic treatment of patients with metastatic carcinoid tumors where it suppresses or inhibits the severe diarrhea and flushing episodes associated with the disease.
Usual Adult Dose for Vasoactive Intestinal Peptide Tumor:
Initial dose: 200 to 300 mcg per day, IV or subcutaneously, in 2 to 4 divided doses
Maintenance dose: 150 to 750 mcg per day
-Doses above 450 mcg per day are not usually required.
Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):
Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 2 months; continue with dose of regular octreotide for at least 2 weeks (at same dose patient was on before the switch)
After 2 months:
-If symptoms are controlled, consider reducing dose to 10 mg every 4 weeks
-If symptoms are not adequately controlled, increase to 30 mg every 4 weeks
Comments:
-Adjust dose for therapeutic response.
Use: Long term treatment of the profuse watery diarrhea associated with Vasoactive Intestinal Peptide (VIP) secreting tumors.
Usual Adult Dose for Acromegaly:
Initial dose: 50 mcg, IV or subcutaneously, 3 times a day
Maintenance dose: Usually 100 mcg, 3 times a day
Maximum dose: 500 mcg, 3 times a day
Comments:
-Starting at a low dose may help patients adapt to gastrointestinal adverse events.
-Use IGF-1 (somatomedin C) levels, every 2 weeks, to guide titration.
-Multiple growth hormone levels, zero to 8 hours after dosing, may permit more rapid dose titration.
-Doses over 300 mcg per day seldom provide additional biochemical benefit.
Long-Acting depot formulation (Establish tolerability with short acting product for at least 2 weeks before using this formulation):
Initial dose: 20 mg, IM (intragluteally), at 4 week intervals, for 3 months
After 3 months:
-If GH is 1 ng/mL or less, IGF-1 normal, and clinical symptoms controlled: 10 mg, IM, every 4 weeks
-If GH is 2.5 ng/mL or less and clinical symptoms controlled: 20 mg, IM, every 4 weeks
-If GH is higher than 2.5 ng/mL and/or clinical symptoms uncontrolled: 30 mg, IM, every 4 weeks
-If GH, IGF-1, or symptoms are not adequately controlled at 30 mg, may increase dose to 40 mg IM every 4 weeks
Maximum dose: 40 mg, every 4 weeks
Comments:
-The goal is growth hormone (GH) levels under 5 ng/mL, or IGF-1 levels under 1.9 U/mL (male) or 2.2 U/mL (female).
-If increased doses do not provide additional benefit, reduce dose.
-Check IGF-1 or growth hormone levels every 6 months.
-For patients who have received irradiation: withdraw medication yearly for about 4 weeks (8 weeks for long-acting formulation) to assess disease activity; if growth hormone or IGF-1 increase and symptoms recur, resume therapy.
Use: To reduce blood levels of growth hormone and IGF-1 (somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection or radiotherapy.
 Detailed Sandostatin dosage information
What happens if I miss a dose?
Call your doctor for instructions if you miss a dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include severe upper stomach pain, diarrhea, weight loss, warmth or tingling, numbness or cold feeling, unexplained muscle pain, weakness, weak pulse, fainting, or slow breathing (breathing may stop).
