Octreotide injections

Octreotide is used to treat persistently low blood sugar levels (hypoglycaemia) caused by the body producing too much insulin (hyperinsulinism).

It is a man-made version of the natural hormone, somatostatin, which stops certain cells in the pancreas releasing insulin. It can be used alone or together with the medicines diazoxide and chlorothiazide as directed by your child’s doctor.

The use of octreotide in children is not currently licensed in the UK. Medicines are often used outside of their license (off-label) in children because trial data is not available for a specific use. This is not necessarily hazardous but should be explained and agreed before use. Your doctor will explain this further to you.

Octreotide for injection is available as different strengths, which can be injected under the skin (subcutaenously). At Great Ormond Street Hospital (GOSH), we use a multi-dose vial, which can be used for up to 10 injections. The strength of this injection solution is 1mg of active ingredient in 5ml of liquid. The solution also contains water and preservatives.

How is octreotide given?

Octreotide is given as a subcutaneous injections, three to four times a day.

Who should not use octreotide injections?

People with the following conditions should discuss taking these medicines with their doctor:

• hypersensitivity to octreotide or any of its ingredients
• pregnant, could be pregnant, trying to become pregnant or breastfeeding

What are the side effects of octreotide?

If any of these side effects are severe or carry on for a long time, please tell your doctor:

• skin reactions affecting the injection site
• loss of appetite, sickness, tummy pain, bloating and/or diarrhoea
• gall bladder or liver problems, possibly showing as yellowing of the skin or whites of the eyes
• hair loss

Octreotide and interactions with other medicines

Some medicines can react with octreotide, altering how well they work. Always check with your doctor or pharmacist before giving your child any other medicines, including herbal or complementary medicines. The following are known to react with octreotide:

• ciclosporin
• anti-diabetic medicines such as insulin or metformin
• anti-reflux medicines, particularly cimetidine

Important information about octreotide

• Keep medicines in a safe place where children cannot reach them.
• Keep the injection ampoules in the fridge in their original packaging. They should be taken out of the fridge and kept at room temperature for giving the injections. They will keep at room temperature for up to two weeks.
• If you are using the multi-dose vial, you should also keep this in the fridge but take it out an hour before giving an injection so it reaches room temperature. Do not use this vial more than 10 times.
• If you forget to give your child a dose and it is within a few hours of when the dose was due, give it as soon as you remember. Otherwise, do not give this dose but wait until the next dose is due. Do not give a double dose.
• If your doctor decides that your child should stop having these injections or they pass the expiry date, return any remaining vials or ampoules to your pharmacist. Do not flush them down the toilet or throw them away.

Last reviewed by Great Ormond Street Hospital: October 2009

Ref: 09F0870 © GOSH Trust October 2009
Compiled by the Pharmacy and Endocrinology departments in collaboration with the Child and Family Information Group

Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.

Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.