Description

Sandostatin LAR Injection in Pakistan – Uses, Dosage, Side Effects & Price

Overview

Sandostatin LAR is an advanced long-acting injection manufactured by Novartis. It contains Octreotide Acetate, a synthetic analog of the natural hormone somatostatin, and is widely prescribed for:

• Acromegaly – a hormonal disorder caused by excess growth hormone.

• Neuroendocrine tumors – such as carcinoid tumors and VIPoma, which can cause severe diarrhea, flushing, and hormonal imbalances.

By regulating hormone secretion, Sandostatin LAR helps control symptoms, improve quality of life, and may even slow tumor progression.

Brand & Composition

• Brand Name: Sandostatin LAR

• Active Ingredient: Octreotide Acetate

• Manufacturer: Novartis

• Drug Class: Somatostatin analog (hormone regulator)

• Formulation: Long-acting intramuscular injection

• Price in Pakistan: Rs. 33,000 – Rs. 38,000 (may vary by city and supplier)

Mechanism of Action – How Sandostatin Works

Sandostatin LAR mimics somatostatin, a natural hormone that regulates secretion of other hormones in the body. Its key actions include:

• Regulating Growth Hormone (GH): Reduces excessive GH production in acromegaly.

• Suppressing Tumor Hormones: Controls hormone release from neuroendocrine tumors, easing diarrhea, flushing, and abdominal discomfort.

• Hormone Inhibition: Blocks GH, glucagon, insulin, TSH, serotonin, VIP, gastrin, and other GI hormones.

• Improved Symptom Control: Reduces gastrointestinal motility, decreases splanchnic blood flow, and manages hormonal side effects.

• Long-lasting release: One injection provides sustained therapeutic effect for up to 4 weeks.

Indications – What Sandostatin LAR Treats

Sandostatin LAR is indicated for:

• Acromegaly – reducing symptoms like enlarged hands/feet, headaches, and fatigue.

• Carcinoid Tumors – controlling diarrhea, flushing, and hormone-related issues.

• VIPoma (Vasoactive Intestinal Peptide Tumors) – managing severe watery diarrhea and electrolyte imbalance.

• Other Neuroendocrine Tumors – symptom relief and potential slowing of tumor progression.

Dosage & Administration

• Starting Dose: 20mg intramuscular injection every 4 weeks.

• Adjustment After 2 Months:

  • Reduce to 10mg if symptoms are controlled.

  • Increase to 30mg if symptoms persist.

  • Maximum recommended dose: 30mg every 4 weeks.

• Special Cases:

  • Renal impairment (dialysis patients): Start with 10mg every 4 weeks.

  • Liver impairment: Requires close monitoring.

⚠️ Note: Sandostatin LAR must be administered intramuscularly by a trained healthcare professional, usually in the gluteal muscle.

Benefits of Sandostatin LAR

• ✅ Regulates growth hormone in acromegaly.

• ✅ Controls symptoms of carcinoid tumors & VIPoma (diarrhea, flushing).

• ✅ Sustained action with once-monthly injection.

• ✅ Improves quality of life by reducing disease symptoms.

• ✅ Potential tumor growth control in neuroendocrine cancers.

Side Effects of Sandostatin LAR

Common Side Effects:

• Nausea, abdominal pain, diarrhea or constipation

• Fatigue, headache, dizziness

• Pain or irritation at injection site

Serious Side Effects:

• Gallstones (cholelithiasis) due to reduced gallbladder activity

• Blood sugar changes:

  • Hypoglycemia (~3% of patients)

  • Hyperglycemia (~16% of patients)

• Bradycardia (slow heart rate)

• Liver enzyme changes

Warnings & Precautions

• Blood Sugar Monitoring: Adjust diabetes medications if needed.

• Gallbladder Monitoring: Risk of gallstone formation.

• Cardiac Function: Use cautiously in patients with heart disorders.

• Thyroid Function: Long-term use may affect thyroid levels.

• Drug Interactions: May interact with cyclosporine, beta-blockers, bromocriptine, antiarrhythmics (quinidine, sotalol, etc.).

• Pregnancy & Breastfeeding: Classified as FDA Pregnancy Category B. Use only if clearly needed.

Storage & Handling

• Store in a refrigerator (2°C to 8°C) – do not freeze.

• Once prepared, use within 24 hours if kept at room temperature.

• Supplied as a single-dose kit (drug vial + prefilled diluent syringe).