Sandostatin is a brand-name prescription drug. It’s FDA-approved for use in adults with:

  • Acromegaly. Acromegaly is a condition that causes excess growth of your bones and body tissues.
  • Severe diarrhea or flushing related to carcinoid tumors that are metastatic. Flushing refers to warmth and redness in your skin. A carcinoid tumor is a type of cancer that usually develops in your lungs or digestive tract. And “metastatic” means that the cancer has spread to other parts of your body.
  • Severe watery diarrhea related to vasoactive intestinal peptide tumors. These tumors usually develop in your pancreas.

Sandostatin contains the active drug octreotide acetate. This is the artificial form of a natural hormone called somatostatin.

Sandostatin vs. Sandostatin LAR Depot

This article covers two forms of Sandostatin:

  • immediate-release Sandostatin (“Immediate release” means the drug is released into your body as soon as it’s injected.)
  • extended-release Sandostatin LAR Depot (“Extended release” means the drug is released slowly into your body over time after it’s injected.)

Both Sandostatin and Sandostatin LAR Depot contain the active drug octreotide acetate.

Both forms of Sandostatin are approved for the same uses. But extended-release Sandostatin LAR Depot is approved for use only in adults who have already used immediate-release Sandostatin and the drug worked for them.

Sandostatin and Sandostatin LAR Depot are given as different types of injections. For details on this as well as drug strengths, see the “Sandostatin dosage” section below.

Effectiveness

For information on the effectiveness of Sandostatin and Sandostatin LAR Depot, see the “Sandostatin uses” section below.

Extended-release Sandostatin LAR Depot is available only as a brand-name medication. It’s not currently available in generic form.

Immediate-release Sandostatin is available as a generic drug called octreotide acetate. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

In some cases, the brand-name drug and the generic version may come in different forms and strengths.

The Food and Drug Administration (FDA) approves prescription drugs to treat certain conditions.

The FDA approved two forms of Sandostatin: immediate-release Sandostatin and extended-release Sandostatin LAR Depot. “Immediate release” means the drug is released into your body as soon as it’s injected. “Extended release” means the drug is released slowly into your body over time after it’s injected.

Sandostatin and Sandostatin LAR Depot may be used off-label. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Sandostatin for acromegaly

Sandostatin and Sandostatin LAR Depot are FDA-approved to treat a condition called acromegaly in adults.

Acromegaly explained

Acromegaly causes excess growth of your bones and body tissues. This extra growth happens over a long period of time. Acromegaly is usually diagnosed in adults ages 45 to 65 years, but the condition is very rare.

Symptoms of acromegaly may include:

  • an increase in body odor
  • an increase in the size of your face, ears, feet, or hands
  • an increase in the spaces between your teeth
  • darkened or enlarged skin tags (small growths of skin that hang from your skin’s surface)
  • deeper voice
  • oily, rough, or thick skin

Acromegaly occurs when your pituitary gland (a small gland located near the bottom of your brain) releases too much growth hormone. This is usually caused by a pituitary adenoma, which is a noncancerous tumor on your pituitary gland. The tumor can cause your pituitary gland to make more growth hormone than your body needs.

Growth hormone triggers your liver to release another hormone called insulin-like growth factor-1 (IGF-1). IGF-1 can cause your bones and body tissues to grow. IGF-1 can also affect the way your body breaks down lipids (fats) and blood glucose (blood sugar). Too much growth hormone and IGF-1 can lead to other health problems, such as arthritis.

Effectiveness for acromegaly

In adults with acromegaly, Sandostatin and Sandostatin LAR Depot have been found effective for lowering blood levels of growth hormone and IGF-1.

Clinical studies have evaluated both forms of Sandostatin for acromegaly. Adults with acromegaly were first given immediate-release Sandostatin. Each person received this form of Sandostatin for different amounts of time. Some people had already been using this drug before the study started. Some of the people had used Sandostatin for a few weeks, while others had been using it for up to 10 years. The amount of time that people used immediate-release Sandostatin during the study isn’t known.

Immediate-release Sandostatin and growth hormone levels

Immediate-release Sandostatin was effective for lowering the average monthly growth hormone levels to less than:

  • 5 nanograms per milliliter (ng/mL) in 78% to 95% of adults who used the drug
  • 2.5 ng/mL in 50% to 69% of adults who used the drug
  • 1 ng/mL in 7% to 21% of adults who used the drug

A normal growth hormone level is usually less than 5 ng/mL. However, some healthcare providers may consider levels less than 10 ng/mL to be normal.

Immediate-release Sandostatin and IGF-1 levels

Immediate-release Sandostatin was also effective for lowering IGF-1 levels to a normal range in 41% to 67% of adults who used the drug. (A normal IGF-1 level depends on a person’s age and gender. For adult males, Sandostatin is typically considered effective if their IGF-1 blood level is less than 1.9 units/mL. For adult females, Sandostatin is typically considered effective if their IGF-1 blood level is less than 2.2 units/mL.)

Sandostatin LAR Depot and levels of growth hormone and IGF-1

Adults who had the following growth hormone blood levels after using immediate-release Sandostatin were switched to extended-release Sandostatin LAR Depot:

  • less than 10 ng/mL or
  • less than half of the growth hormone blood level that was measured before they started treatment with Sandostatin

Some adults received up to 28 doses of extended-release Sandostatin LAR Depot. Of the people in this group, the drug was effective for lowering the average monthly growth hormone levels to less than:

  • 5 ng/mL in 83% to 97% of adults who used the drug
  • 2.5 ng/mL in 47% to 66% of adults who used the drug
  • 1 ng/mL in 11% to 23% of adults who used the drug

Extended-release Sandostatin LAR Depot was also effective for lowering IGF-1 levels to a normal range in 51% to 67% of adults who used the drug.

Sandostatin for diarrhea and flushing related to metastatic carcinoid tumors

Sandostatin and Sandostatin LAR Depot are FDA-approved to treat severe diarrhea and flushing (warmth and redness in your skin) related to metastatic carcinoid tumors. A carcinoid tumor is a type of cancer that usually develops in your lungs or digestive system. Your digestive system includes your stomach, small intestine, and large intestine. And “metastatic” means that the cancer has spread to other parts of your body, such as the pancreas or liver.

The specific symptoms of a carcinoid tumor depend on the location of the tumor. You may not experience any symptoms of a carcinoid tumor until you’ve had it for several years. Possible symptoms you may experience include:

  • abdominal (belly) pain
  • chest pain
  • diarrhea
  • flushing
  • nausea and vomiting
  • pain or bleeding from your rectum (the end portion of your large intestine)
  • skin marks that look like stretch marks
  • trouble breathing
  • weight gain

Effectiveness for diarrhea and flushing related to metastatic carcinoid tumors

Sandostatin and Sandostatin LAR Depot have been found effective for treating diarrhea and flushing related to metastatic carcinoid tumors.

Clinical studies have evaluated the effectiveness of both immediate-release Sandostatin and extended-release Sandostatin LAR Depot for diarrhea and flushing. Adults with these conditions were first given immediate-release Sandostatin. Some people kept using immediate-release Sandostatin during the study. Other people were switched to extended-release Sandostatin LAR Depot. It’s not known how long each person received immediate-release Sandostatin before switching.

In adults who kept using immediate-release Sandostatin:

  • Their average number of daily stools decreased from 3.7 to 2.6 a day.
  • Their average number of daily flushing episodes decreased from 3 to 0.5 episodes a day.

In adults who were switched to extended-release Sandostatin LAR Depot:

  • Their average number of daily stools decreased from 4 to 4.9 stools a day to 2.1 to 2.8 stools a day.
  • Their average number of daily flushing episodes decreased from 3 to 6.1 episodes a day to 0.6 to 1.0 episodes a day.

Sandostatin for diarrhea related to vasoactive intestinal peptide tumors

Sandostatin and Sandostatin LAR Depot are FDA-approved to treat severe watery diarrhea caused by vasoactive intestinal peptide (VIP) tumors. A VIP tumor is a type of cancer that usually develops in your pancreas. The tumor causes your pancreas to secrete the VIP hormone, which stimulates the release of water into your digestive system. This can lead to severe watery diarrhea.

Possible symptoms of a VIP tumor can include:

Effectiveness for diarrhea related to vasoactive intestinal peptide tumors

Sandostatin has been found effective for treating diarrhea related to VIP tumors. Clinical guidelines recommend using somatostatin analogs, such as Sandostatin, as a first-line treatment for this condition. (Sandostatin is a type of drug called a somatostatin analog. And “first-line” is the first treatment used.)

Both immediate-release Sandostatin and extended-release Sandostatin LAR Depot are used for treatment of diarrhea related to VIP tumors. It’s recommended that immediate-release Sandostatin be used first. If it works to treat the condition, then you may be switched to extended-release Sandostatin LAR Depot after 2 weeks. For more information, see the “Sandostatin dosage” section below.

Sandostatin for other conditions

In addition to the uses listed above, Sandostatin and Sandostatin LAR Depot may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Sandostatin and Sandostatin LAR Depot are used for certain other conditions. Below is information on other possible uses for Sandostatin and Sandostatin LAR Depot.

Sandostatin for GI bleeds (off-label use)

Sandostatin and Sandostatin LAR Depot aren’t FDA-approved to treat gastrointestinal (GI) bleeds. GI bleeds may occur in your stomach or intestines.

Some experts recommend using Sandostatin or Sandostatin LAR Depot off-label to treat GI bleeding caused by esophageal varices. Esophageal varices are swollen blood vessels located near the bottom of your esophagus. Esophageal varices are commonly caused by cirrhosis. (Cirrhosis is a condition that occurs when your liver tissues become scarred after many years of liver damage.)

Cirrhosis makes it hard for blood to flow through your liver. This can cause blood to back up and lead to the formation of varices around your esophagus. Esophageal varices can burst, causing a GI bleed. If you have a severe GI bleed, you may experience bloody diarrhea that looks black or like tar.

If you have questions about using Sandostatin or Sandostatin LAR Depot for GI bleeds caused by esophageal varices, talk with your doctor.

Sandostatin for dumping syndrome (off-label use)

Sandostatin and Sandostatin LAR Depot aren’t FDA-approved to treat dumping syndrome. (This condition occurs when your stomach empties its contents into your small intestine more quickly than usual.)

However, Sandostatin and Sandostatin LAR Depot may be used off-label to treat dumping syndrome. Clinical studies have looked at both these medications. Researchers found the drugs to be effective for controlling the symptoms of dumping syndrome in people whose symptoms didn’t respond to other treatments.

Talk with your doctor if you’re interested in using Sandostatin or Sandostatin LAR Depot for dumping syndrome.

Sandostatin for hypoglycemia (off-label use)

Sandostatin and Sandostatin LAR Depot aren’t FDA-approved to treat hypoglycemia (low blood sugar).

However, immediate-release Sandostatin may be used off-label to treat hypoglycemia caused by sulfonylureas. Sulfonylureas are a group of medications used to treat diabetes. And hypoglycemia is a common side effect of these drugs.

Hypoglycemia occurs if your blood sugar drops below a certain level. For most people with diabetes, a normal blood sugar level is above 70 milligrams per deciliter (mg/dL). Symptoms of hypoglycemia may occur if your blood sugar level falls below this level. Symptoms can include:

Clinical studies have found immediate-release Sandostatin to be effective for treating hypoglycemia caused by sulfonylureas.

Talk with your doctor if you have questions about using immediate-release Sandostatin for this purpose.

Sandostatin for neuroendocrine tumors (off-label use)

Sandostatin and Sandostatin LAR Depot aren’t FDA-approved for the treatment of neuroendocrine tumors. (A neuroendocrine tumor is a type of rare cancer that grows around your pancreas.)

However, Sandostatin and Sandostatin LAR Depot may be used off-label to treat neuroendocrine tumors. In clinical studies, these drugs have been shown to help prevent neuroendocrine tumor cells from copying themselves and growing.

If you’re interested in using Sandostatin or Sandostatin LAR Depot to treat your neuroendocrine tumor, talk with your doctor. They’ll be able to recommend the best treatment options for you.

Sandostatin for pancreatitis (not an appropriate use)

Sandostatin and Sandostatin LAR Depot aren’t FDA-approved for the treatment of pancreatitis (swelling of your pancreas). They should not be used to treat it.

In fact, pancreatitis is a possible side effect of these drugs. For more information, see the “Sandostatin side effects” section below.

Talk with your doctor if you have questions about treatments for pancreatitis.

Sandostatin and children

Sandostatin and Sandostatin LAR depot shouldn’t be used in children. Clinical studies haven’t shown these drugs to be safe or effective when used in children.

The Food and Drug Administration (FDA) has approved Sandostatin and Sandostatin LAR to treat acromegaly as well as diarrhea and flushing related to certain types of tumors. Your doctor may prescribe other medications with Sandostatin to treat other aspects of your acromegaly or tumors.

Talk with your doctor to learn more about other medications you may be taking with Sandostatin or Sandostatin LAR Depot.

Sandostatin and Sandostatin LAR Depot can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Sandostatin and Sandostatin LAR Depot. These lists don’t include all possible side effects.

Side effects may differ slightly among people with acromegaly, carcinoid tumors, or vasoactive intestinal peptide tumors. Side effects may also differ slightly between immediate-release Sandostatin and extended-release Sandostatin LAR Depot.

For more information on the possible side effects of Sandostatin and Sandostatin LAR Depot, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Sandostatin and Sandostatin LAR Depot, you can do so through MedWatch.

Mild side effects

Mild side effects of Sandostatin can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Sandostatin. To learn about other mild side effects, talk with your doctor or pharmacist, or see the prescribing information for immediate-release Sandostatin and extended-release Sandostatin LAR Depot.
† For more information on this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Sandostatin aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information on these side effects, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Sandostatin or Sandostatin LAR Depot. In clinical studies of immediate-release Sandostatin, less than 1% of people had an allergic reaction. It isn’t known how many people had an allergic reaction to extended-release Sandostatin LAR Depot. Also, the studies didn’t compare the drugs against other medications or a placebo (treatment with no active drug).

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Sandostatin or Sandostatin LAR Depot. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Injection site pain

Injection site pain may occur when using Sandostatin or Sandostatin LAR Depot.

Depending on the dose and condition being studied:

  • In clinical studies of immediate-release Sandostatin, 7.7% of adults experienced injection site pain.
  • In clinical studies of extended-release Sandostatin LAR Depot, between 2% and 50% of adults experienced injection site pain.

It isn’t known how many adults had injection site pain after using other medications or placebos to treat their condition.

If you experience bothersome injection site pain while using Sandostatin or Sandostatin LAR Depot, talk with your doctor. They may be able to suggest ways to lessen injection site pain with these drugs.

Changes in blood sugar levels

The use of Sandostatin or Sandostatin LAR Depot may cause changes in blood glucose (blood sugar) levels. These changes may lead to hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Sandostatin and hypoglycemia

In clinical studies of Sandostatin and Sandostatin LAR Depot, the percentage of adults who developed hypoglycemia after using either form of Sandostatin varied depending on the condition being studied. The percentage of adults who had hypoglycemia after using other medications to treat their condition isn’t known.

Hypoglycemia occurs if your blood sugar drops below a certain level. For most people without diabetes, a normal blood sugar level is more than 70 milligrams per deciliter (mg/dL). Symptoms of hypoglycemia may occur if your blood sugar level falls below 70 mg/dL. Symptoms can include:

Sandostatin and hyperglycemia

In clinical studies of Sandostatin and Sandostatin LAR Depot, the percentage of adults who developed hyperglycemia after using either form of Sandostatin varied depending on the condition being studied. The percentage of adults who had hypoglycemia after using other medications to treat their condition isn’t known.

Hyperglycemia occurs if your blood sugar rises above a certain level. For most people without diabetes, a normal blood sugar level is below 140 mg/dL. Symptoms of hyperglycemia may occur if your blood sugar level reaches 180 mg/dL or higher. Symptoms can include:

  • blurry vision
  • feeling more thirsty than usual
  • headache
  • tiredness
  • trouble concentrating
  • urinating more often than usual
  • weight loss

Talking with your doctor

If you experience symptoms of hypoglycemia or hyperglycemia while using Sandostatin or Sandostatin LAR Depot, talk with your doctor. They may want to monitor your blood sugar more closely.

Heart problems

Heart problems may occur after the use Sandostatin or Sandostatin LAR Depot. In clinical studies, adults who took immediate-release Sandostatin or extended-release Sandostatin LAR had heart problems, including:

  • sinus bradycardia (a type of slow heartbeat)
  • conduction abnormalities (problems with the heart’s electrical pathways)
  • arrhythmias (irregular heartbeat)

Here’s how often the side effects occurred in adults who took each drug, depending on the condition being treated:

Immediate-release SandostatinExtended-release Sandostatin LAR Depot
Sinus bradycardia25%19% to 25%
Conduction abnormalities10%9% to 10%
Arrhythmias9%3% to 9%

The percentage of adults who had heart problems after using other medications to treat their condition isn’t known.

The symptoms you may experience depend on your specific heart problem. Examples of symptoms you may have include:

  • increased or decreased heart rate
  • changes in heart rate or rhythm
  • fainting

Talk with your doctor if you’re concerned about experiencing heart problems while using Sandostatin or Sandostatin LAR Depot. They may monitor you more closely during your treatment.

Gallstones

Gallstones are a common side effect of Sandostatin and Sandostatin LAR Depot use. Gallstones occur when substances in your gallbladder harden into small stones. Your gallbladder is a small organ located on the right side of your abdomen (belly).

Researchers found that:

  • In clinical studies of immediate-release Sandostatin, 27% of all adults who used the drug developed gallstones.
  • Of all adults who used extended-release Sandostatin LAR Depot in clinical studies, 22% to 24% developed gallstones.

It isn’t known how many adults had gallstones after using other medications or placebos to treat their condition.

Your likelihood of experiencing gallstones while using Sandostatin or Sandostatin LAR Depot may increase over time. In clinical studies of Sandostatin and Sandostatin LAR Depot:

  • In adults* who used immediate-release Sandostatin for 1 month, less than 2% developed gallstones.
  • In adults* who used either form of Sandostatin for at least 12 months, 52% developed gallstones or other problems with their gallbladder.

* Across all conditions the drug is approved to treat

Other gallbladder problems

You may also experience other problems with your gallbladder while using Sandostatin or Sandostatin LAR Depot.

In clinical studies of all adults who used immediate-release Sandostatin:

  • 24% developed gallbladder sludge (a buildup of calcium, cholesterol, bilirubin, and other substances in your gallbladder). Gallbladder sludge may cause gallstones or other gallbladder problems.
  • 12% experienced biliary duct dilation (an increase in the size of the bile duct). Your bile duct is the pathway that connects your liver to your gallbladder. Gallstones may travel through your biliary duct, causing the duct to increase in size. In the clinical studies, one person who used immediate-release Sandostatin died from biliary duct dilation.

In clinical studies of all adults who used extended-release Sandostatin LAR Depot, 52% to 62% developed gallbladder problems.

It isn’t known how many adults had other gallbladder problems after using other drugs or placebos to treat their condition.

Symptoms of gallstones

Symptoms of gallstones may include:

  • feelings of restlessness
  • pain in your back, shoulder, or right side of your body
  • nausea and vomiting
  • sweating

Tell your doctor right away if you experience any symptoms of gallstones or other gallbladder problems while using Sandostatin or Sandostatin LAR Depot. Your doctor may want to temporarily stop your Sandostatin treatment until your gallstones have been treated.

There are two versions of Sandostatin: immediate-release Sandostatin and extended-release Sandostatin LAR Depot. “Immediate release” means the drug is released into your body as soon as it’s injected. “Extended release” means the drug is released slowly into your body over time after it’s injected.

The Sandostatin or Sandostatin LAR Depot dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using the drug to treat
  • your age
  • the form of Sandostatin you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage of immediate-release Sandostatin. Then they’ll adjust it over time to reach the dosage that’s right for you. If this form of Sandostatin is working to treat your condition without causing serious side effects, then your doctor may switch you to extended-release Sandostatin LAR Depot. They’ll ultimately prescribe the dosage and form of Sandostatin that provides the desired effect while causing the fewest side effects.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Here’s some information about the forms and strengths of immediate-release Sandostatin and extended-release Sandostatin LAR Depot.

Immediate-release Sandostatin

Immediate-release Sandostatin comes as a liquid solution. The drug is given as an injection in three possible forms:

  • subcutaneous (an injection just under your skin)
  • intravenous (an injection into a vein)
  • infusion (an injection into a vein that’s given over a period of time)

Immediate-release Sandostatin is usually given as a subcutaneous injection. A healthcare provider can teach you or a caregiver how to give the injections at home.

However, injection site pain is a common side effect of subcutaneous Sandostatin injections. If you have pain near the injection site, your doctor may have you try a different form of Sandostatin. In this case, you may receive the intravenous or infusion form of Sandostatin in a doctor’s office or clinic.

Immediate-release Sandostatin comes in a vial in the following strengths: 50 micrograms (mcg) per milliliter (mL), 100 mcg/mL, and 500 mcg/mL.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot comes as a suspension (a type of mixture in liquid). The drug is given as an intramuscular injection (an injection into a muscle). A healthcare provider will give you the injections in your gluteal muscle, more commonly known as your buttocks. You’ll receive the injections in a doctor’s office, a clinic, or your home.

Extended-release Sandostatin LAR Depot is available in the following strengths: 10 milligrams (mg), 20 mg, and 30 mg.

Dosage for acromegaly

Both forms of Sandostatin are used to treat acromegaly.

Immediate-release Sandostatin

When used to treat acromegaly, the typical dosage of immediate-release Sandostatin is 50 mcg three times a day. The dosage may be increased to 500 mcg three times a day. The subcutaneous injection dosage and the intravenous (IV) drip dosage are the same.

Your doctor may give you a different dosage depending on several factors, including your age and whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

If immediate-release Sandostatin is working for you and you’re able to tolerate it for at least 2 weeks, your doctor may switch you to extended-release Sandostatin LAR Depot.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot is also used to treat acromegaly if you have tolerated immediate-release Sandostatin treatment. For this purpose, the typical starting dosage is 20 mg injected into your buttocks every 4 weeks. This dosage is given for at least 3 months. After the first 3 months, the typical dose range for Sandostatin LAR Depot is 10 mg to 40 mg every 4 weeks.

The dosage your doctor gives you after the first 3 months will depend on several factors, including:

  • your blood levels* of growth hormone and insulin-like growth factor-1 (IGF-1)
  • how well Sandostatin LAR Depot is controlling your symptoms of acromegaly
  • your age
  • whether you have kidney disease
  • whether you have liver disease

If you have questions about the dosage that’s right for you, talk with your doctor.

* For more information about blood tests during treatment with Sandostatin, see “Will I need to have any lab tests while I’m using Sandostatin?” in “Common questions about Sandostatin” below.

Dosage for diarrhea and flushing related to metastatic carcinoid tumors

Both forms of Sandostatin are used to treat diarrhea and flushing (warmth and redness in your skin) related to metastatic carcinoid tumors.

Immediate-release Sandostatin

For this purpose, the typical dosage of immediate-release Sandostatin is 100 mcg to 600 mcg a day given in two to four divided doses. This dose is given for at least 2 weeks. The maximum recommended dosage is 750 mcg a day.

Your doctor may give you a different dosage depending on several factors, including your age and whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

If immediate-release Sandostatin is working for you and you’re able to tolerate it for at least 2 weeks, your doctor may switch you to extended-release Sandostatin LAR Depot.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot is also used to treat diarrhea and flushing related to metastatic carcinoid tumors. For this purpose, the typical dosage is 20 mg injected into your buttocks every 4 weeks. This dose is given for at least 2 months. After the first 2 months, the typical dose range for Sandostatin LAR Depot is 10 mg to 30 mg every 4 weeks.

Dosage for diarrhea related to vasoactive intestinal peptide tumors

Both forms of Sandostatin are used to treat diarrhea related to vasoactive intestinal peptide (VIP) tumors.

Immediate-release Sandostatin

For this purpose, the typical dosage of immediate-release Sandostatin is 200 mcg to 300 mcg a day given in two to four divided doses. This dosage is given for at least 2 weeks. The maximum recommended dosage is 450 mcg a day.

Your doctor may give you a different dosage depending on several factors, including your age and whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

If immediate-release Sandostatin is working for you and you’re able to tolerate it for at least 2 weeks, your doctor may switch you to extended-release Sandostatin LAR Depot.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot is also used to treatdiarrhea related to VIP tumors. The typical dosage is the same as the dosage for diarrhea related to metastatic carcinoid tumors. For details, see “Dosage for diarrhea and flushing related to metastatic carcinoid tumors” above.

What if I miss a dose?

If you miss a dose of immediate-release Sandostatin, inject the missed dose as soon as you remember. If it’s almost time for your next dose, skip the missed dose and go back to your usual dosing schedule.

If you miss a dose of extended-release Sandostatin LAR Depot, call your doctor’s office to reschedule an appointment as soon as possible.

To help make sure that you don’t miss a dose of immediate-release Sandostatin, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

To help you remember your appointments for injections of extended-release Sandostatin LAR Depot, you can put your treatment schedule on a calendar.

Will I need to use this drug long term?

It’s typically recommended that immediate-release Sandostatin be used as a short-term treatment. If the drug is working for you and you’re able to tolerate it for at least 2 weeks, your doctor may switch you to extended-release Sandostatin LAR Depot.

Sandostatin LAR Depot is meant to be used as a long-term treatment. If you and your doctor determine that Sandostatin is safe and effective for you, you’ll likely take it long term.

You should use Sandostatin according to your doctor’s or healthcare provider’s instructions.

There are two versions of Sandostatin: immediate-release Sandostatin and extended-release Sandostatin LAR Depot. “Immediate release” means the drug is released into your body as soon as it’s injected. “Extended release” means the drug is released slowly into your body over time after it’s injected.

Immediate-release Sandostatin

Immediate-release Sandostatin is given as an injection in three possible forms:

  • subcutaneous (an injection just under your skin)
  • intravenous (an injection into a vein)
  • infusion (an injection into a vein that’s given over a period of time)

These forms may also be referred to as routes of administration. Immediate-release Sandostatin is usually given as a subcutaneous injection. A healthcare provider can teach you or a caregiver how to give the injections at home. You should rotate the subcutaneous injection sites to prevent irritation.

However, injection site pain is a common side effect of subcutaneous Sandostatin injections. If you have pain near the injection site, your doctor may have you try a different form of Sandostatin. In this case, you may receive the intravenous (IV) or infusion form of Sandostatin in a doctor’s office or clinic.

If your doctor has you receive Sandostatin as an IV injection or an infusion, the drug may be given:

  • over a short period of time
  • over a period of 3 minutes if given as an IV
  • over a period of 15 to 30 minutes

Typically, your doctor will have you receive an IV injection given over a short period of time. However, injection site pain can also occur with these forms of Sandostatin. If you feel pain near the injection site while receiving an IV injection or infusion, your doctor may give you a smaller amount of drug over a longer period of time.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot is given as an intramuscular injection (an injection into a muscle). A healthcare provider will give you the injections in your gluteal muscle, more commonly known as your buttocks. They’ll rotate the LAR injection sites to prevent irritation.

You’ll receive the injections in a doctor’s office, a clinic, or your home.

When to have injections

You’ll likely use immediate-release Sandostatin between two and four times each day. You should self-inject at the same time each day. You should also try to spread out your doses over the same number of hours each day. For example, if you use immediate-release Sandostatin twice a day, it’s best to have a dose about every 12 hours.

To help make sure that you don’t miss a dose of immediate-release Sandostatin, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

For extended-release Sandostatin LAR Depot, you’ll likely receive the drug one time every 4 weeks. A healthcare provider will give you the injections in a doctor’s office, a clinic, or your home.

To help you remember your appointments for injections of extended-release Sandostatin LAR Depot, you can put your treatment schedule on a calendar.

Other drugs are available that can treat your acromegaly, diarrhea, or flushing related to certain types of cancers. Some medications may be a better fit for you than others. If you’re interested in finding an alternative to Sandostatin or Sandostatin LAR Depot, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for acromegaly

Examples of other drugs that may be used to treat acromegaly include:

  • cabergoline
  • lanreotide acetate (Somatuline Depot)
  • pasireotide (Signifor, Signifor LAR)
  • pegvisomant (Somavert)
  • temozolomide (Temodar)

Alternatives for diarrhea and flushing related to metastatic carcinoid tumors

Examples of other drugs that may be used to treat symptoms related to metastatic carcinoid tumors include:

  • cholestyramine resin (Questran)
  • colesevelam (Welchol)
  • colestipol (Colestid)
  • cyproheptadine
  • diphenoxylate/atropine (Lomotil)
  • lanreotide acetate (Somatuline Depot)
  • loperamide (Imodium A-D)
  • ondansetron (Zofran)
  • telotristat ethyl (Xermelo)

Alternatives for diarrhea related to vasoactive intestinal peptide tumors

Examples of other drugs that may be used to treat diarrhea related to vasoactive intestinal peptide (VIP) tumors include:

  • diphenoxylate/atropine (Lomotil)
  • loperamide (Imodium A-D)

You may wonder how Sandostatin and Sandostatin LAR Depot compare with other medications that are prescribed for similar uses. Here we look at how Sandostatin and Sandostatin LAR Depot are alike and different from Somatuline Depot.

Ingredients

Sandostatin and Sandostatin LAR Depot contain the active ingredient octreotide acetate.

Somatuline Depot contains the active ingredient lanreotide acetate.

Uses

Here’s a list of conditions that the Food and Drug Administration (FDA) has approved Sandostatin, Sandostatin LAR Depot, and Somatuline Depot to treat.

  • Both Sandostatin and Somatuline Depot are FDA-approved to treat certain forms of:
  • Sandostatin is also FDA-approved to treat:
    • severe watery diarrhea related to vasoactive intestinal peptide (VIP) tumors
  • Somatuline Depot is also FDA-approved to treat:

For details on the uses of Sandostatin and Somatuline Depot, see the “Sandostatin uses” section above. For more information on the uses of Somatuline Depot, talk with your doctor.

Drug forms and administration

Sandostatin comes in two versions: immediate-release Sandostatin and extended-release Sandostatin LAR Depot. Here’s some information the forms and administration of those drugs and of Somatuline Depot.

Immediate-release Sandostatin

Immediate-release Sandostatin comes as a liquid solution. The drug is given as an injection in three possible ways:

  • subcutaneous (an injection just under your skin)
  • intravenous (an injection into a vein)
  • infusion (an injection into a vein that’s given over a period of time)

Immediate-release Sandostatin is usually given as a subcutaneous injection. A healthcare provider can teach you or a caregiver how to give these injections at home. How often you receive the drug depends on the condition you’re being treated for. See the “Sandostatin dosage” section above to learn more.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot comes as a suspension (a type of mixture in liquid).

The drug is given as an intramuscular injection (an injection into a muscle). A healthcare provider will give you the injections in your gluteal muscle, more commonly known as your buttocks. You’ll receive the injections in a doctor’s office, a clinic, or your home.

How often you receive Sandostatin LAR Depot depends on the condition you’re being treated for. Refer to the “Sandostatin dosage” section above for more information.

Somatuline Depot

Somatuline Depot comes as a liquid in a single-dose prefilled syringe. The drug is given as a subcutaneous injection only by a healthcare provider. You’ll likely receive a dose once every 4 weeks.

Side effects and risks

Sandostatin, Sandostatin LAR Depot, and Somatuline Depot are in a class of drugs called somatostatin analogs. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Sandostatin, with Somatuline Depot, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Sandostatin, with Somatuline Depot, or with both drugs (when taken individually).

Effectiveness

Sandostatin, Sandostatin LAR Depot, and Somatuline Depot have different FDA-approved uses. However, they’re both used to treat certain forms of acromegaly as well as severe diarrhea and flushing related to carcinoid tumors.

These drugs haven’t been directly compared in clinical studies, but studies have found Sandostatin, Sandostatin LAR Depot, and Somatuline Depot to be effective for treating these conditions.

Costs

According to estimates on WellRx.com, the costs of Sandostatin, Sandostatin LAR Depot, and Somatuline Depot vary depending on your treatment plan. The actual price you’ll pay for also depends on your insurance plan, your location, and the pharmacy you use.

Sandostatin, Sandostatin LAR Depot, and Somatuline Depot are brand-name drugs.

Sandostatin is available as a generic drug called octreotide acetate. There are currently no generic forms of Sandostatin LAR Depot and Somatuline Depot. Brand-name medications usually cost more than generics.

Like Somatuline Depot (above), the drug Xermelo has uses similar to those of Sandostatin. Here’s a comparison of how Sandostatin and Sandostatin LAR Depot are alike and different from Xermelo.

Ingredients

Sandostatin and Sandostatin LAR Depot contain the active ingredient octreotide acetate.

Xermelo contains the active ingredient telotristat ethyl.

Uses

Here’s a list of conditions that the Food and Drug Administration (FDA) has approved Sandostatin, Sandostatin LAR Depot, and Xermelo to treat.

  • Both Sandostatin and Xermelo are FDA-approved to treat:
  • Sandostatin is also FDA-approved to treat:
    • severe flushing (warmth and redness in your skin) related to metastatic carcinoid tumors
    • severe watery diarrhea related to vasoactive intestinal peptide (VIP) tumors

For details on the uses of Sandostatin and Somatuline Depot, see the “Sandostatin uses” section above. For more information on the use of Xermelo, talk with your doctor.

Drug forms and administration

Sandostatin comes in two versions: immediate-release Sandostatin and extended-release Sandostatin LAR Depot. Here’s some information the forms and administration of those drugs and of Xermelo.

Immediate-release Sandostatin

Immediate-release Sandostatin comes as a liquid solution. The drug is given as an injection in three possible ways:

  • subcutaneous (an injection just under your skin)
  • intravenous (an injection into a vein)
  • infusion (an injection into a vein that’s given over a period of time)

Immediate-release Sandostatin is usually given as a subcutaneous injection. A healthcare provider can teach you or a caregiver how to give these injections at home. How often you receive the drug depends on the condition you’re being treated for. See the “Sandostatin dosage” section above to learn more.

Extended-release Sandostatin LAR Depot

Extended-release Sandostatin LAR Depot comes as a suspension (a type of mixture in liquid). The drug is given as an intramuscular injection (an injection into a muscle). A healthcare provider will give you the injections in a doctor’s office, a clinic, or your home. How often you receive the drug depends on the condition you’re being treated for. Refer to the “Sandostatin dosage” section above for more information.

Xermelo

Xermelo comes as a tablet that you swallow. You’ll likely take the drug three times each day.

Side effects and risks

Sandostatin, Sandostatin LAR Depot, and Xermelo are all used to treat severe diarrhea related to certain forms of carcinoid tumors. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Sandostatin, with Xermelo, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Sandostatin, with Xermelo, or with both drugs (when taken individually).

Effectiveness

Sandostatin, Sandostatin LAR Depot, and Xermelo have different FDA-approved uses, but they’re each used to treat severe diarrhea related to certain forms of carcinoid tumors.

These drugs haven’t been directly compared in clinical studies, but studies have found Sandostatin, Sandostatin LAR Depot, and Xermelo to be effective for treating this condition.

Costs

According to estimates on WellRx.com, costs of Sandostatin, Sandostatin LAR Depot, and Xermelo will vary depending on your treatment plan. The actual price you’ll pay also depends on your insurance plan, your location, and the pharmacy you use.

Sandostatin, Sandostatin LAR Depot, and Xermelo are brand-name drugs.

Sandostatin is available as a generic drug called octreotide acetate. There are currently no generic forms of Sandostatin LAR Depot and Xermelo. Brand-name medications usually cost more than generics.

Here are answers to some frequently asked questions about Sandostatin and Sandostatin LAR Depot.

Is Sandostatin a chemotherapy drug?

No, Sandostatin and Sandostatin LAR Depot aren’t chemotherapy drugs. Chemotherapy drugs work to kill cells, such as cancer cells, that are growing quickly. Chemotherapy drugs can’t tell the difference between cancer cells and healthy cells. Therefore, chemotherapy can damage healthy cells, possibly causing many side effects.

Sandostatin and Sandostatin LAR Depot contain the active drug octreotide acetate. This is the artificial form of a natural hormone called somatostatin. Octreotide acetate works by mimicking the activity of somatostatin in your body. For more information, see the “How Sandostatin works” section below.

Can Sandostatin be used to treat carcinoid syndrome?

Yes. Sandostatin and Sandostatin LAR Depot can be used to treat certain symptoms of carcinoid syndrome. This is a collection of symptoms related to carcinoid tumors. Carcinoid syndrome occurs when a carcinoid tumor releases the chemical serotonin into your bloodstream. This can lead to severe diarrhea and flushing (warmth and redness in your skin).

The Food and Drug Administration (FDA) has approved Sandostatin and Sandostatin LAR Depot to treat severe diarrhea and flushing related to metastatic carcinoid tumors. “Metastatic” means that the cancer has spread to other parts of your body.

If you have questions about using Sandostatin and Sandostatin LAR Depot for carcinoid syndrome, talk with your doctor.

Does Sandostatin shrink tumors?

In certain cases. Sandostatin and Sandostatin LAR Depot aren’t FDA-approved to treat tumors. However, these drugs are sometimes used off-label to treat neuroendocrine tumors. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition. For more information, see “Sandostatin for neuroendocrine tumors (off-label use)” in the “Sandostatin uses” section above.

Sandostatin and Sandostatin LAR Depot are FDA-approved to treat certain symptoms of carcinoid tumors and vasoactive intestinal peptide tumors. But clinical trials haven’t studied the drugs’ effects on tumor size, tumor growth, or the spread of cancer related to those conditions.

Talk with your doctor if you have questions about the best treatment for your tumor.

Should I follow a certain diet while I’m using Sandostatin?

Yes. Some foods and drinks may worsen diarrhea and flushing related to certain types of tumors. Examples of foods and drinks that may worsen these symptoms include:

For more dietary recommendations related to managing your diarrhea or flushing symptoms, visit the Sandostatin LAR Depot manufacturer site.

You can also ask your doctor for advice on what to consume and what to avoid during your Sandostatin treatment.

If I have diabetes, can I take Sandostatin?

Perhaps. Sandostatin may cause changes in your blood glucose (blood sugar) levels. If you use insulin or other medications to treat your diabetes, your doctor may need to change your dosage of these medications after you start using Sandostatin. They may also decide to monitor your blood sugar levels more often.

If you have questions about using Sandostatin when you have diabetes, talk with your doctor.

Will I need to have any lab tests while I’m using Sandostatin?

Yes, your doctor may want to do certain lab tests to check how well Sandostatin or Sandostatin LAR Depot is working for you. The type of lab tests you’ll need depends on the condition you’re using Sandostatin to treat and what issues your doctor will want to monitor:

  • If you’re taking Sandostatin or Sandostatin LAR Depot for acromegaly, your doctor may monitor your levels of growth hormone and insulin-like growth factor-1 (IGF-1). This is because Sandostatin and Sandostatin LAR Depot should decrease the levels of these two hormones.
  • If you have a carcinoid tumor, your doctor may monitor your levels of substances called 5-hydroxyindole acetic acid (5-HIAA), serotonin, and substance P. Sandostatin or Sandostatin LAR Depot should decrease the levels of these three substances.
  • If you have a vasoactive intestinal peptide (VIP) tumor, your doctor may monitor your levels of VIP hormone. Sandostatin or Sandostatin LAR Depot should decrease the levels of this hormone.

In addition, your doctor may monitor your blood sugar, thyroid hormone, and vitamin B12 levels while you use Sandostatin or Sandostatin LAR Depot. This is because the drugs may cause changes in your blood sugar levels, possibly leading to low blood sugar or high blood sugar. The drugs may also cause hypothyroidism (low levels of thyroid hormone). And they may cause your body to absorb less vitamin B12 than usual.

For more information, see the “Sandostatin side effects” section above.

Talk with your doctor if you have any questions about tests you’ll need during your treatment with Sandostatin or Sandostatin LAR Depot.

There are no known interactions between Sandostatin or Sandostatin LAR Depot and alcohol. However, drinking alcohol can cause flushing (warmth and redness in your skin). This may worsen symptoms of flushing related to metastatic carcinoid tumors.

Talk with your doctor about the amount of alcohol that may be safe for you to drink while using Sandostatin or Sandostatin LAR Depot.

Immediate-release Sandostatin and extended-release Sandostatin LAR Depot can interact with several other medications. “Immediate release” means the drug is released into your body as soon as it’s injected. “Extended release” means the drug is released slowly into your body over time after it’s injected.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Sandostatin and other medications

Below are medications that can interact with Sandostatin and Sandostatin LAR Depot. This section doesn’t contain all drugs that may interact with Sandostatin and Sandostatin LAR Depot.

Before taking Sandostatin or Sandostatin LAR Depot, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Sandostatin and medications that lower heart rate

Heart problems, such as sinus bradycardia and arrhythmia, are a possible side effect of Sandostatin and Sandostatin LAR Depot. Using medications that lower your heart rate, such as beta-blockers and calcium channel blockers, may increase your risk of this side effect. (For more information, see the “Sandostatin side effects” section above.)

Examples of beta-blockers include:

Examples of calcium channel blockers include:

  • amlodipine (Norvasc)
  • verapamil (Calan)
  • diltiazem (Cardizem)

Before starting Sandostatin or Sandostatin LAR Depot treatment, be sure to tell your doctor about any other medications that you take. They can determine whether any of the drugs lower your heart rate and adjust your treatment plan as needed.

Sandostatin and bromocriptine

Sandostatin and Sandostatin LAR Depot may inhibit (block) the breakdown of bromocriptine in your body. This could raise the level of bromocriptine in your body and increase your risk of side effects from bromocriptine.

If you take bromocriptine while using Sandostatin or Sandostatin LAR Depot, your doctor may adjust your dose or recommend a different drug.

Sandostatin and cyclosporine

Sandostatin and Sandostatin LAR Depot may induce (speed up) the breakdown of cyclosporine in your body. This could decrease the level of cyclosporine in your body and make cyclosporine less effective.

If you take cyclosporine, talk with your doctor before using Sandostatin or Sandostatin LAR Depot. They may recommend a different medication to treat your condition.

Sandostatin and medications broken down by CYP3A4

CYP3A4 is an enzyme your body uses to break down certain medications. Sandostatin and Sandostatin LAR Depot may inhibit (block) this enzyme in your body. Blocking CYP3A4 can raise the level of certain drugs in your blood, increasing your risk of side effects from these medications.

Quinidine is an example of a medication that’s broken down by the CYP3A4 enzyme.

Before starting Sandostatin or Sandostatin LAR Depot treatment, tell your doctor about any medications you take. They can determine if any are broken down by the CYP3A4 enzyme. Your doctor may adjust your doses or recommend other medications.

Sandostatin and medications used to treat diabetes

Sandostatin and Sandostatin LAR Depot may cause changes in your blood glucose (blood sugar) levels. If you use insulin or other oral medications to treat your diabetes, your doctor may need to change your dosage after you start using either form of Sandostatin. They may also decide to monitor your blood sugar levels more often.

Examples of insulin include:

  • insulin aspart (NovoLog)
  • insulin glargine (Lantus)
  • insulin lispro (Humalog)

Examples of oral diabetes medications include:

Talk with your doctor if you have concerns about managing your blood sugar while using Sandostatin or Sandostatin LAR Depot.

Sandostatin and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Sandostatin or Sandostatin LAR Depot. However, Sandostatin and Sandostatin LAR Depot may cause your body to absorb less vitamin B12.

During treatment with Sandostatin and Sandostatin LAR Depot, your doctor may check your vitamin B12 level. If your level is low, they may decide to give you a vitamin B12 supplement (such as a vitamin B12 shot) while you’re using these drugs. Talk with your doctor if you have questions about your vitamin B12 level while taking Sandostatin or Sandostatin LAR Depot.

While using Sandostatin or Sandostatin LAR Depot, be sure to check with your doctor or pharmacist before taking any herbs and supplements.

Sandostatin and foods

There aren’t any foods that have been specifically reported to interact with Sandostatin or Sandostatin LAR Depot. However, Sandostatin and Sandostatin LAR Depot may affect the way your body absorbs fat from the foods and drinks you consume.

Because of this side effect, you may need to lower the amount of fat in your diet. Talk with your doctor about how much fat you can consume while taking these drugs.

Some foods and drinks may also worsen diarrhea and flushing related to certain types of tumors. For more information, see “Should I follow a certain diet while I’m using Sandostatin?” in the “Common questions about Sandostatin” section above.

If you have any questions about eating certain foods with Sandostatin or Sandostatin LAR Depot, talk with your doctor.

As with all medications, the cost of immediate-release Sandostatin and extended-release Sandostatin LAR Depot can vary. “Immediate release” means the drug is released into your body as soon as it’s injected. “Extended release” means the drug is released slowly into your body over time after it’s injected.

To find current prices for Sandostatin and Sandostatin LAR Depot in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Sandostatin and Sandostatin LAR Depot at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively. After getting Sandostatin LAR Depot from a specialty pharmacy, you’ll likely take the injection to a doctor’s office, a clinic, or your home to be given by a healthcare provider.

Before approving coverage for Sandostatin or Sandostatin LAR Depot, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Sandostatin or Sandostatin LAR Depot, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Sandostatin or Sandostatin LAR Depot, or if you need help understanding your insurance coverage, help is available.

Novartis Pharmaceuticals Corporation, the manufacturer of Sandostatin and Sandostatin LAR Depot, offers a copay card that may lower the cost of Sandostatin LAR Depot. The manufacturer also offers a program called Patient Assistance Now Oncology (PANO). This program can assist you in obtaining insurance coverage for Sandostatin LAR Depot.

For more information and to find out if you’re eligible for support, visit the manufacturer’s website. To learn about the copay card, call 877-577-7756. And to learn more about PANO, call 800-282-7630.

For information about ways to lower the cost of Sandostatin, talk with your doctor or pharmacist.

Generic version

Sandostatin LAR Depot isn’t available in a generic form. However, Sandostatin is available in a generic form called octreotide acetate.

A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. To find out how the cost of octreotide acetate injection compares with the cost of Sandostatin, visit WellRx.com.

If your doctor has prescribed Sandostatin and you’re interested in using octreotide acetate injection instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Acromegaly occurs when your pituitary gland (a small gland located near the bottom of your brain) releases too much growth hormone. Growth hormone triggers your liver to release another hormone called insulin-like growth factor-1 (IGF-1). IGF-1 can cause your bones and body tissues to grow.

A carcinoid tumor is a type of cancer that usually develops in your lungs or digestive system. The tumor can make substances similar to hormones that cause severe diarrhea or flushing.

A vasoactive intestinal peptide (VIP) tumor is a type of cancer that usually develops in your pancreas. The tumor causes your pancreas to secrete the VIP hormone, which stimulates the release of water into your digestive system. This can lead to severe watery diarrhea.

What Sandostatin does

Sandostatin contains the active drug octreotide acetate, which is the artificial form of a natural hormone called somatostatin.

Different tissues in your body produce somatostatin. The hormone’s main function is to help prevent your body from making other hormones. Somatostatin also works to stop your body from forming groups of cells that may become tumors or cancer.

Octreotide acetate works by mimicking the activity of somatostatin in your body.

How long does it take to work?

Sandostatin starts working right away to treat your condition. Your symptoms should ease within several hours of receiving an injection of immediate-release Sandostatin. “Immediate release” means the drug is released into your body as soon as it’s injected.

The other form of Sandostatin (extended-release Sandostatin LAR Depot) is meant to be used after your symptoms are stable. “Extended release” means the drug is released slowly into your body over time after it’s injected.

You may not notice Sandostatin LAR Depot working in your body. Even while taking Sandostatin LAR Depot, you may still have symptoms of your condition from time to time. In these cases, your doctor may have you use immediate-release Sandostatin for a short period of time until your symptoms are stable again.

It’s not known whether Sandostatin and Sandostatin LAR Depot are safe to use during pregnancy. No studies of either drug have been conducted in pregnant women.

If you’re pregnant or planning to become pregnant, talk with your doctor before using Sandostatin or Sandostatin LAR Depot. They can advise you on the risks and benefits of the drugs and what other treatment options are available.

Sandostatin and fertility

Sandostatin and Sandostatin LAR Depot don’t affect fertility, which is the ability to become pregnant. But for some women, acromegaly may cause infertility (an inability to become pregnant). Acromegaly is a condition that causes excess growth of your bones and body tissues. This happens as a result of too much growth hormone in your body.

When used to treat acromegaly, Sandostatin and Sandostatin LAR Depot lower your level of growth hormone. When the level decreases, some women with infertility caused by acromegaly are able to become pregnant.

Talk with your doctor if you have questions about your ability to get pregnant while using Sandostatin and Sandostatin LAR Depot.

It’s not known if Sandostatin and Sandostatin LAR Depot are safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using either of these drugs.

For more information about taking Sandostatin and Sandostatin LAR Depot during pregnancy, see the “Sandostatin and pregnancy” section above.

For women using Sandostatin

If you’re able to become pregnant, you should use birth control while taking Sandostatin or Sandostatin LAR Depot. Talk with your doctor about birth control options that may be best for you.

For men using Sandostatin

The manufacturer of Sandostatin and Sandostatin LAR Depot hasn’t given birth control recommendations for men using these drugs. If you’re a man using Sandostatin or Sandostatin LAR Depot and your sexual partner can become pregnant, talk with your doctor. They can review your birth control needs while using this drug.

It’s not known if Sandostatin and Sandostatin LAR Depot can pass into human breast milk. Based on animal studies, these drugs may be able to pass into breast milk. However, animal studies don’t always predict what will happen in humans.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of using Sandostatin and Sandostatin LAR Depot.

Before taking Sandostatin or Sandostatin LAR Depot, talk with your doctor about your health history. These drugs may not be right for you if you have certain medical conditions or other factors affecting your health, including:

  • Diabetes. Tell your doctor if you have diabetes before starting Sandostatin treatment. The drug may cause changes in your blood glucose levels. If you use insulin or other medications to treat your diabetes, your doctor may need to change your dosage after you start using Sandostatin. Your doctor may also decide to monitor your blood sugar levels more frequently. For more information, see the “Sandostatin side effects” section above.
  • Heart problems. Using Sandostatin may cause new or worsening heart disease, such as problems with your heart rate or rhythm. Be sure to tell your doctor if you have any heart problems before starting Sandostatin treatment. For more information, see the “Sandostatin side effects” section above.
  • Total parenteral nutrition. Taking Sandostatin to treat severe diarrhea while also using total parenteral nutrition may increase the level of zinc in your blood. This increase can cause other health problems, including diarrhea. Be sure to tell your doctor if you’re using total parenteral nutrition before you start Sandostatin treatment. They may want to monitor your zinc blood levels.
  • Allergic reaction. If you’ve had an allergic reaction to Sandostatin, Sandostatin LAR Depot, or any of their ingredients, you shouldn’t take the drugs. Ask your doctor what other medications are better options for you.
  • Pregnancy. It’s not known if Sandostatin and Sandostatin LAR Depot are safe to use during pregnancy. For more information, please see the “Sandostatin and pregnancy” section above.
  • Breastfeeding. It’s not known if Sandostatin and Sandostatin LAR Depot can pass into human breast milk. For more information, please see the “Sandostatin and breastfeeding” section above.

Note: For more information about the potential negative effects of Sandostatin and Sandostatin LAR Depot, see the “Sandostatin side effects” section above.

Using more than the recommended dosage of immediate-release Sandostatin* can lead to serious side effects. (“Immediate release” means the drug is released into your body as soon as it’s injected.)

Do not use more Sandostatin than your doctor recommends.

* Because Sandostatin LAR Depot is given by a healthcare provider, it’s unlikely you’ll have an overdose with this form.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get immediate-release Sandostatin from the pharmacy, the pharmacist will add an expiration date to the label on the carton. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

For long-term storage, you should keep Sandostatin ampoules (small glass bottles) in the refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). Be sure to keep the ampoules in their outer carton for protection from light.

If you keep Sandostatin out of the light, you can store the drug at a room temperature of 68°F to 86°F (20°C to 30°C) for up to 14 days. Before using the drug, you can let it warm to room temperature naturally. (Don’t heat Sandostatin in a microwave, for example.) And avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

Right after you’ve used a syringe or needle, dispose of it in an FDA-approved sharps disposal container. This helps prevent others, including children and pets, from taking the drug by accident or harming themselves with the needle. You can buy a sharps container online, or ask your doctor, pharmacist, or health insurance company where to get one.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Both immediate-release Sandostatin and extended-release Sandostatin LAR Depot are approved for the following conditions:

  • acromegaly
  • severe diarrhea or flushing associated with metastatic carcinoid tumors
  • profuse watery diarrhea associated with vasoactive intestinal peptide (VIP)-secreting tumors

However, Sandostatin LAR Depot is approved for use in adults who have already responded to treatment with Sandostatin.

Administration

Sandostatin is administered by subcutaneous or intravenous injection. Sandostatin may be administered by the patient or a caregiver. Sandostatin LAR Depot is administered intramuscularly and should only be given by a healthcare professional.

Mechanism of action

Sandostatin and Sandostatin LAR Depot contain the active drug octreotide acetate. Octreotide acetate is the synthetic form of the natural hormone somatostatin. Octreotide acetate mimics the activity of somatostatin and is a more potent inhibitor of glucagon, growth hormone, and insulin. Octreotide acetate also inhibits the response of luteinizing hormone, gastrin, motilin, pancreatic polypeptide, secretin, serotonin, and vasoactive intestinal peptide.

These mechanisms contribute to the function of Sandostatin and Sandostatin LAR Depot in treating flushing and diarrhea.

Pharmacokinetics and metabolism

Information on the pharmacokinetics and metabolism of Sandostatin and Sandostatin LAR Depot is as follows.

Sandostatin

Sandostatin achieved peak concentrations of 5.2 ng/mL within 0.4 hours of subcutaneous dosing in healthy volunteers. In people given subcutaneous Sandostatin to treat their acromegaly, peak concentrations were achieved within 0.7 hours. The elimination half-life of Sandostatin is between 1.7 and 1.9 hours, and each dose has a 12-hour duration of action. About 32% of each Sandostatin dose is eliminated into the urine as unchanged drug.

Dose adjustments may be required in older adults or in patients with renal or hepatic disease.

Sandostatin LAR Depot

Octreotide acetate is released slowly from Sandostatin LAR Depot microspheres. After intramuscular injection, Sandostatin LAR Depot reached peak concentrations within 1 hour of administration to healthy volunteers, with plateau concentrations maintained over 2 to 3 weeks.

Dose-proportional peak concentrations of Sandostatin LAR Depot were achieved after single doses of 10 mg, 20 mg, and 30 mg in people with acromegaly. The resulting peak concentrations were 0.3 ng/mL, 0.8 ng/mL, and 1.3 ng/mL. Plateau concentrations were reached over 3 weeks after Sandostatin LAR Depot injection and were sustained for 2 weeks.

Contraindications

Sandostatin is contraindicated in individuals with known sensitivity to octreotide acetate or any ingredients in the formulation. There are no known contraindications to Sandostatin LAR Depot.

Storage

Sandostatin and Sandostatin LAR Depot should be stored at refrigerated temperatures of 36°F to 46°F (2°C to 8°C). Each should be kept in its outer carton for protection from light.

If protected from light, Sandostatin is stable at a room temperature of 68°F to 86°F (20°C to 30°C) for up to 14 days.

Both forms of Sandostatin should be kept at room temperature for 30 to 60 minutes before use. Sandostatin LAR Depot should be administered immediately after reconstitution.

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