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
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
- 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.
Nurse: This is a short film showing you how to give an injection just under your skin. This is called a subcutaneous or sub cut injection. This does not replace what your doctors and nurses tell you, so always follow their advice.
Voiceover: Subcutaneous injections may be part of your cancer treatment. Or, you may need them to prevent side effects of treatment, such as blood clots after surgery. Or to help control cancer symptoms, such as pain or sickness.
Most injections come in prefilled syringes.
Nurse: So, today I am going to show you how to give a subcutaneous injection. I am going to start by giving it into a practice cushion and then you can have a go at giving one yourself. Before you start, you need to get your equipment together. What you are going to need is an alcohol wipe to clean your skin, some cotton wool, a prefilled syringe and a sharps bin. It is important that you wash your hands with soap and water and dry them thoroughly before you start. Check that you have got the correct drug and that it is in date.
You can give the injection into the back of your arm, your tummy, your thigh or the outer part of your bottom. It is important that you vary where you give the injection. So it may be that you give it one day in your tummy and the next in your thigh.
So you start by cleaning the skin with the alcohol wipe and allowing it to air dry. Then you take the cover off the needle and pinch the skin up and hold it a bit like a pen and in an upright position, in a quick dart like motion pop it straight down into the skin. Then you press the plunger right to the end, quickly pull the needle out, dab it with cotton wool, pop the needle into the sharps bin. And then you need to wash your hands again.
So here’s what you are going to need. If you start by checking the drug and the expiry date. And then with the alcohol wipe give your skin a clean. That’s it give it a few seconds for the air to dry it. Ok and then if you want to pick up the syringe and take the cover off the needle. Then pinch your skin up and at a ninety degree angle gently push the needle in...then press the plunger...and then quickly remove it... dab your skin with the cotton wool and put the syringe in the sharps bin.
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.
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.
When to contact your team
Your doctor, nurse, or pharmacist 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
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 healthcare team 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.
Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.
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.
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.
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. Let your team know straight away if you or your partner falls pregnant while 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.
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. For example, 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.