Octreotide (Sandostatin)

Octreotide (also known as Sandostatin) is a man made (synthetic) version of the natural hormone somatostatin. 

You might have it as a treatment:

  • for carcinoid syndrome
  • to control the growth of some advanced neuroendocrine tumours (NETs) when surgery is not possible 

Carcinoid syndrome is a group of symptoms that some people get when they have a neuroendocrine tumour (NET) Open a glossary item. The symptoms happen when the NET makes large amounts of hormones. 

Carcinoid syndrome is more common in people with a NET that has spread to the liver.

How does octreotide work?

Somatostatin is a hormone made naturally in the body. It slows down or stops the production of a number of hormones such as insulin and gut hormones. It also controls the emptying of the stomach and bowel.

Octreotide is a synthetic version of somatostatin (a somatostatin analogue) and slows down the production of hormones. This helps to control the symptoms of carcinoid syndrome and slow down the growth of the cancer.

Some of the symptoms you may have with carcinoid syndrome include flushing of the skin, diarrhoea and tummy (abdominal) pain.

How do you have octreotide?

You might have octreotide as an injection under the skin (subcutaneous) or into the muscle (intramuscular).

Most people have octreotide is as an injection under the skin.

As an injection under your skin

You have these under the skin into your:

  • upper arms
  • thighs
  • tummy (abdomen)

Your skin at the injection site might go red and itchy for some time after the injection. It’s important that you vary where you give the injection if you have it every day. For example one day you may give it in your tummy and the next in your thigh.

The video below shows you how to give an injection under the skin. 

As an injection into the muscle

Your nurse gives you the injection in your bottom. They vary the site of the injection. So you might have one injection on the right side and the next injection on the left.

You usually have a stinging or dull ache for a short time, but they don’t usually hurt much. 

How often do you have octreotide?

When you have octreotide depends on your individual needs. Ask your doctor or nurse when are you going to have it and for how long.

There are 2 types of octreotide:

  • short acting
  • long acting (also called Sandostatin LAR)

Short acting octreotide

Short acting octreotide starts to work straight away. But the drug only stays in your body for a short period of time. This means that you need to have octreotide injections more often. 

You usually have short acting octreotide as injections under the skin once or twice a day.

Long acting octreotide

Long acting octreotide is slowly absorbed by the body. This means that the drug stays in your body for longer.

You usually have long acting octreotide as an injection into the muscle in your bottom once every 4 weeks.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of octreotide?

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.

When to contact your team

Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse
Early treatment can help manage side effects better.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Diarrhoea or constipation

Tell your doctor or nurse if you have diarrhoea or constipation. They can give you medicine to help. 

Feeling sick (nausea)

Feeling sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Having Octreotide subcutaneous injections between meals or when you go to bed may help to reduce this.

Tummy (abdominal) pain and bloating

Octreotide might cause tummy pain, or less often can make you feel bloated. Tell your healthcare team if you have this. They can check the cause and give you medicine to help.

Headaches

Tell your doctor or nurse if you keep getting headaches. They can give you painkillers to help.

Gallstones

Gallstones are hard lumps, like little rocks that form in the gallbladder. In most cases, they don’t cause symptoms and you don’t need to have treatment unless you have:

  • a high temperature
  • severe and sudden tummy (abdominal) pain
  • yellowing of the skin and the whites of your eyes (jaundice)

Changes in blood sugar levels

High blood sugar levels can cause headaches, feeling thirsty and blurred vision.

Less commonly your blood sugar level may be low. This can make you may feel shaky, sweat more than usual, or feel confused.

You have regular tests to check your blood sugar levels. You may need to check your levels more often if you are diabetic.

Inflammation at the injection site

Tell your nurse if you notice any redness, swelling or pain at your injection site.

Wind (flatulence)

You may pass more wind than usual. 

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

  • heartburn or indigestion
  • being sick – let your healthcare team know as you can have medicine to help stop this
  • dizziness and tiredness, do not drive or operate machinery if you have these particular side effects
  • low levels of thyroid hormones that can make you feel tired or cold and can make you feel depressed
  • liver changes that may cause yellowing of the skin and the whites of your eyes (jaundice), or your wee (urine) may look darker
  • skin problems such as a rash and itchy skin
  • hair loss or thinning of your hair
  • shortness of breath
  • general weakness
  • poo (stool) that floats, looks pale or has a bad smell caused by undigested fat - your poo may also change in colour
  • loss of appetite
  • inflammation of the gall bladder (cholecystitis), you might feel or be sick, have tummy pain, and a high temperature - call your health care team if you have any symptoms
  • a build up of substances in the gall bladder (biliary sludge), symptoms might include tummy pain, feeling sick, or being sick, especially after a fatty meal
  • a slow heartbeat - symptoms can include feeling lightheaded, dizzy and weak

Rare side effects

These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:

  • a lack of fluid in the body (dehydration)
  • a fast heartbeat- you might have symptoms such as feeling that your heart is beating very fast or you may have shortness of breath

Other side effects

Some people may have an allergic reaction, but this is rare. There isn't enough information to work out how often this might happen.

Allergic reaction

This can cause a rash, shortness of breath, redness or swelling of the face, and dizziness. Some allergic reactions can be life-threatening.

Alert your nurse or doctor straight away if you notice any of these symptoms and you are in the hospital or call 999 (emergency services) if you are at home.

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drinks

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Loss of fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Contraception and pregnancy

It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment.

Talk to your doctor or nurse about effective contraception you can use during treatment. Ask how long you should use it before starting treatment and after treatment has finished.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Last reviewed: 
08 Apr 2021
Next review due: 
08 Apr 2024
  • Electronic Medicines Compendium
    Accessed November 2020

  • Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system 
    K Oberg and others 
    Annals of Oncology, 2004. Vol 15, Pages 966-973 

  • Octreotide- Scottish Palliative Care Guidelines
    Health Improvement Scotland, 2019

  • Scottish Neuroendocrine Tumour Group - Consensus Guidelines for the Management of Patients with Neuroendocrine Tumours​​
    NHS Scotland, 2015

  • Somatostatin Analogues in the Treatment of Neuroendocrine Tumors: Past, Present and Future
    A Stueven and others 
    International Journal of Molecular Sciences, 2019

Related links