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Dosage for Acromegaly
This section offers dosage guidelines for Sandostatin® LAR® for the treatment of acromegaly.
Dosing Algorithm in Acromegaly
Sandostatin LAR is designed to be injected intramuscularly (intragluteally) once every 4 weeks. It should never be administered intravenously or subcutaneously. When beginning treatment with Sandostatin LAR, a specific procedure must be followed:
Sandostatin LAR for Acromegaly
Patients not currently receiving Sandostatin LAR should begin therapy with subcutaneous (SC) Sandostatin Injection at an initial dose of 50 µg 3 times a day. Beginning with this low dose may permit adaptation to adverse gastrointestinal effects for patients who require higher doses. Dosage titration can be based on multiple GH measurements at 0 to 8 hours after administration. The goal is to attempt to normalise GH and IGF-1 levels. Most patients require a dosage of 100 µg to 200 µg 3 times a day for the maximum effect of normalising GH and IGF-1. Some patients may require up to 500 µg 3 times a day. Injection sites should be rotated in a systematic manner to avoid irritation. Patients should be maintained on this formulation for at least 2 weeks to determine their response and tolerability to Sandostatin Injection.
Patients who tolerate the drug and are considered to be responders to therapy based on GH and IGF-1 levels can be switched directly to Sandostatin LAR. The dosage should be 20 mg administered intragluteally at 4-week intervals for the initial 3 months, followed by dosage adjustment.
Patients currently receiving Sandostatin Injection can be switched directly to Sandostatin LAR at a dose of 20 mg administered intragluteally at 4-week intervals for the initial 3 months. Deltoid injections should be avoided because of significant discomfort at the injection site when given in that area. Gluteal injection sites should be alternated to avoid irritation.
At the end of 3 months, the dose of Sandostatin LAR may be continued at the same level or adjusted based on the following regimen:
- GH >1 µg/L and ≤2.5 µg/L
- IGF-1 normal
- Clinical symptoms controlled
- Maintain the dose of Sandostatin LAR at 20 mg every 4 weeks
- GH >2.5 µg/L, and/or
- IGF-1 elevated, and/or
- Clinical symptoms uncontrolled
- Increase dose of Sandostatin LAR to 30 mg every 4 weeks
Disclaimer: This is an international website for Sandostatin® (Octreotide) and is intended for healthcare professionals outside the US. If you are a US resident, please click on the US Residents link at the top of this page. The information on this site is not country-specific and may contain information that is outside the approved indications in the country in which you are located.
