Sandostatin has been associated with alterations in nutrient absorption, so it may have an effect on absorption of orally administered drugs. Concomitant administration of Sandostatin with cyclosporine may decrease blood levels of cyclosporine and result in transplant rejection.
Patients receiving insulin, oral hypoglycemic agents, beta blockers, calcium channel blockers, or agents to control fluid and electrolyte balance, may require dose adjustments of these therapeutic agents.
Concomitant administration of octreotide and bromocriptine increases the availability of bromocriptine. Limited published data indicate that somatostatin analogs might decrease the metabolic clearance of compounds known to be metabolized by cytochrome P450 enzymes, which may be due to the suppression of growth hormones. Since it cannot be excluded that octreotide may have this effect, other drugs mainly metabolized by CYP3A4 and which have a low therapeutic index (e.g., quinidine, terfenadine) should therefore be used with caution.
No frank overdose has occurred in any patient to date. Intravenous bolus doses of 1 mg (1000 mcg) given to healthy volunteers and of 30 mg (30,000 mcg) IV over 20 minutes and of 120 mg (120,000 mcg) IV over eight hours to research patients have not resulted in serious ill effects.
Up-to-date information about the treatment of overdose can often be obtained from a certified Regional Poison Control Center. Telephone numbers of certified Regional Poison Control Centers are listed in the Physicians’ Desk Reference®.*
Mortality occurred in mice and rats given 72 mg/kg and 18 mg/kg IV, respectively.
Drug Abuse and Dependence
There is no indication that Sandostatin has potential for drug abuse or dependence. Sandostatin levels in the central nervous system are negligible, even after doses up to 30,000 mcg.