Has been reported isolated cases of overdose of Sandostatin in adults and children in clinical practice. In case of accidental use of Sandostatin in adults at a dose of 2400-6000 mg / day, administered by intravenous drip (infusion rate of 100-250 micrograms / hour) or subcutaneously (1500 mg 3 times daily) was observed: the development of arrhythmias, lowering blood pressure, a sudden stop heart, brain hypoxia, pancreatitis, fatty liver, diarrhea, weakness, lethargy, weight loss, hepatomegaly, and lactate acidosis.
Subcutaneous administration testosterone cypionate results(divided into more administrations) in patients with tumors of any new adverse events (except as noted see “Side effects”) have been identified.
Interactions with other drugs
Sandostatin reduces the absorption of cyclosporin and slows the absorption of cimetidine.
The combined use of octreotide and bromocriptine increases the bioavailability of bromocriptine.
There is evidence that somatostatin analogs might decrease the metabolic clearance of substances metabolized with the participation of system of cytochrome enzymes, which may be due to the suppression of GR. Because you can not be excluded that octreotide may have this effect, caution should be exercised in the appointment of drugs metabolized isoenzyme and with a narrow range of therapeutic concentrations (eg quinidine, terfenadine).
When pituitary tumors secreting GH, the need for careful monitoring of patients receiving Sandostatin, because it is possible to increase the size of the tumors with the development of serious complications such as narrowing of the visual field. In these cases, you should consider the need for other treatments.
Since reduction in growth hormone levels and normalization of insulin-like growth factor-1 during therapy with octreotide may lead to the restoration of the ability to give birth in women with acromegaly, in the application of patient preparation of childbearing age should use reliable methods contraception. When assigning Sandostatin necessary to monitor thyroid function for a long period of time.
In the case of bradycardia during treatment, if necessary, may reduce the doses of beta-blockers, calcium channel blockers or drugs which affect water and electrolyte balance. Some patients may octreotide modify fat absorption in the intestine. Against the testosterone cypionate results background of octreotide, a decrease content of cobalamin (vitamin B 12 ) and abnormal rates of absorption test cobalamin (Schilling test).
In the application of Sandostatin in patients with a deficiency of vitamin B 12 in the anamnesis is recommended to control the content of cobalamin in the body. Guidelines for the management of patients in Sandostatin treatment time for education gallstones.
- Prior to the appointment of Sandostatin patients should undergo initial ultrasound examination of the gallbladder.
- During treatment with Sandostatin should be repeated ultrasound gallbladder, preferably at intervals of 6-12 months.
- If gallstones are found before the start of the treatment, it is necessary to evaluate the potential benefits of therapy Sandostatin compared with the possible risk associated with their presence. Data about any negative impact on Sandostatin for forecast or already existing cholelithiasis not.
- Management of patients with gall bladder stones are formed during Sandostatin treatment.
- Asymptomatic gallstones .
The use of testosterone cypionate results can stop or continue – in line with the assessment of benefit / risk ratio. In any case, there is no need to do anything except to continue monitoring, making it more frequently if necessary.
- Gallstones with clinical symptoms .
The use of Sandostatin can stop or continue – in line with the assessment of benefit / risk ratio. In any event, the patient should be treated the same as in other cases of cholelithiasis symptomatic.Drug treatment includes the use of combinations of drugs bile acids (e.g., chenodeoxycholic acid at a dose of 7.5 mg / kg per day in combination with ursodeoxycholic acid at the same dose) under ultrasound guidance – until complete disappearance of the stones.
- Asymptomatic gallstones .
In the treatment of endocrine gastrointestinal tumors and pancreatic Sandostatin, in rare cases, there may come a sudden relapse of symptoms.
In patients with insulinomas during treatment with octreotide may experience an increase in the severity and duration of hypoglycemia (this is due to more pronounced overwhelming influence on the secretion of GH and glucagon than insulin secretion, as well as shorter duration of inhibition of insulin secretion). Need to be fully regular monitoring of these patients in the early treatment of Sandostatin, and at each change in dose.
Substantial fluctuations in blood glucose concentration can try to reduce by more frequent administration of smaller doses of Sandostatin. In patients with diabetes mellitus type 1 Sandostatin may reduce insulin requirements. In patients without diabetes, and type 2 diabetes with partially intact insulin secretion Sandostatin administration can result in postprandial hyperglycemia. When using Sandostatin in patients with diabetes are recommended monitoring the concentration of glucose in the blood and the anti-diabetic therapy.
Because after bleeding from varicose veins of the esophagus and the stomach increased risk of developing type 1 diabetes mellitus, and in patients suffering from diabetes, also possible change needs insulin, in these cases the regular control of blood glucose levels.
necessary correction dosing regimen simultaneously used diuretics, beta-blockers, blockers “slow” calcium channels, insulin, oral hypoglycemic agents, glucagon.
Effects on ability to drive vehicles and use machines
on the effect of testosterone cypionate results and road operation with no mechanisms. Running low dose t3 clen cycle trying to lose bodyfat isn’t a real hot idea imo.