The use of octreotide in pregnancy has not been studied. There is limited experience with the drug in pregnant patients with acromegaly in clinical. practice (half of pregnancy outcome was not known).
Most pregnant patients receiving octreotide therapy during the first trimester of pregnancy (in the form of ).
Approximately 70% of cases with patient testosterone enanthate vs cypionate known outcome independently made the decision to continue therapy with the drug during pregnancy. The majority of patients (cases with known outcome) pregnancies ended in the birth of healthy children, but also reported several spontaneous abortions during the first trimester and in cases of abortion.
In the application of octreotide during pregnancy no cases of birth defects in children. Pregnant women drug is prescribed only in case of emergency In experimental studies, octreotide had no direct or indirect negative impact on the course of pregnancy, the formation and maturation of the fetus, childbirth and postnatal development, except for the time delay of growth.
It is unknown whether octreotide in breast milk in humans is allocated in experimental studies indicated the selection of the drug in breast milk. If necessary, use during lactation should stop breastfeeding.
In acromegaly initially the drug is administered at 0.05-0.1 mg subcutaneously at intervals of 8 or 12 hours, further dose adjustment should be based on the monthly determination of the concentration of GH and IGF-1 in the blood (the concentration of the target: testosterone enanthate vs cypionatein the normal range), the analysis of clinical symptoms and tolerability. In most patients, the optimal daily dose is 0.3 mg. Do not exceed the maximum dose is 1.5 mg per day. In patients receiving Sandostatin at a stable dose, determination of the concentration of GH should be made every 6 months] If, after three months of treatment with Sandostatin is not marked enough reducing growth hormone and improving the clinical picture of the disease, therapy should be discontinued.
In endocrine tumors of the gastrointestinal tract and pancreas preparation is administered n / k in the initial dose of 0.05 mg 1-2 times / day. Further, depending on the clinical effect achieved, effect on the levels of hormones produced by the tumor (for carcinoid tumors – influence the selection of 5-hydroxyindoleacetic acid in the urine) and tolerability, the dose can be gradually increased up to 0.1-0.2 mg 3 times / day. In exceptional cases, may require higher doses.
Supporting dose should be adjusted individually.
When carcinoid tumors if therapy testosterone enanthate vs cypionateat the maximum tolerated dose for 1 week was not effective, the treatment should not continue.
When refractory diarrhea in patients with AIDS drug is introduced n / k in the initial dose of 0.1 mg three times / day. If, after one week of treatment the diarrhea subsides, the dose should be increased individually, up to 0.25 mg 3 times / day. Dose adjustment is carried out taking into account the dynamics of the chair and tolerability. If within a week of treatment Sandostatin at a dose of 0.25 mg 3 times a day no improvement occurs, therapy should be discontinued. To prevent complications after surgery on the pancreas is administered s / c at 0.1 mg 3 times / day for 7 consecutive days, beginning on the day operations (at least for 1 hour prior to laparotomy).
When bleeding from esophageal varices and gastric drug is administered in a dose of 25 mg / hr by continuous / in infusion for 5 days. Sandostatin can be diluted with isotonic sodium chloride solution. In patients with liver cirrhosis good tolerability of Sandostatin it was marked by bleeding from esophageal varices, to apply for 5 days to 50 mcg / hour as a continuous I / infusion.
Use in specific patient groups
is currently no data that would indicate that the elderly decreased Sandostatin tolerability and want to change the dosing regimen for them.
Experience with Sandostatin in children is very limited.
Since the data is available to increase the half-life of Octreotide in patients with liver cirrhosis, recommended maintenance dose adjustment in patients with impaired liver function . in patients with impaired renal function testosterone enanthate vs cypionatecorrection mode is not required.