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			{{Short description|Octapeptide that mimics natural somatostatin pharmacologically}}
	{{drugbox
			{{Use dmy dates|date=September 2024}}
	| verifiedrevid = 406330809
			{{cs1 config |name-list-style=vanc |display-authors=6}}
	| IUPAC_name = (4''R'',7''S'',10''S'',13''R'',16''S'',19''R'')-10-(4-aminobutyl)-19-<br><nowiki>amino]-16-<br>benzyl-''N''--7-<br>(1-hydroxyethyl)-13-(1''H''-indol-3-ylmethyl)-6,9,12,<br>15,18-pentaoxo-1,2-dithia-5,8,11,14,17-<br>pentazacycloicosane-4-carboxamide
			{{Infobox drug
	| image = Octreotide.svg
			| Verifiedfields = changed
	| image2 = Octreotide3d.png
			| Watchedfields = changed
	| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
			| verifiedrevid = 458287873
	| ChemSpiderID = 10482007
			| image = Octreotide.svg
	| InChI1 = 1/C49H66N10O10S2/c1-28(61)39(25-60)56-48(68)41-27-71-70-26-40(57-43(63)34(51)21-30-13-5-3-6-14-30)47(67)54-37(22-31-15-7-4-8-16-31)45(65)55-38(23-32-24-52-35-18-10-9-17-33(32)35)46(66)53-36(19-11-12-20-50)44(64)59-42(29(2)62)49(69)58-41/h3-10,13-18,24,28-29,34,36-42,52,60-62H,11-12,19-23,25-27,50-51H2,1-2H3,(H,53,66)(H,54,67)(H,55,65)(H,56,68)(H,57,63)(H,58,69)(H,59,64)/t28-,29?,34-,36+,37+,38-,39-,40+,41+,42+/m1/s1
			| width =
	| InChIKey1 = DEQANNDTNATYII-RRCPSWKPBX
			| alt =
	| smiles = C(O)(CO)NC(=O)5CSSC(NC(=O)(N)Cc1ccccc1)C(=O)N(Cc2ccccc2)C(=O)N(Cc4cnc3ccccc34)C(=O)N(CCCCN)C(=O)N(C(C)O)C(=O)N5
			| image2 = Octreotride PDB-6vc1.png
	| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
			| width2 =
	| StdInChI = 1S/C49H66N10O10S2/c1-28(61)39(25-60)56-48(68)41-27-71-70-26-40(57-43(63)34(51)21-30-13-5-3-6-14-30)47(67)54-37(22-31-15-7-4-8-16-31)45(65)55-38(23-32-24-52-35-18-10-9-17-33(32)35)46(66)53-36(19-11-12-20-50)44(64)59-42(29(2)62)49(69)58-41/h3-10,13-18,24,28-29,34,36-42,52,60-62H,11-12,19-23,25-27,50-51H2,1-2H3,(H,53,66)(H,54,67)(H,55,65)(H,56,68)(H,57,63)(H,58,69)(H,59,64)/t28-,29?,34-,36+,37+,38-,39-,40+,41+,42+/m1/s1
			| alt2 =
	| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
			| caption = 3D structure of octreotide. {{PDB|6VC1}}
	| StdInChIKey = DEQANNDTNATYII-RRCPSWKPSA-N
	| CAS_number = 83150-76-9
	| CAS_supplemental = <br />{{CAS|79517-01-4}} (])<br />{{CAS|135467-16-2}} (])
	| ATC_prefix = H01
	| ATC_suffix = CB02
	| ATC_supplemental =
	| PubChem = 54373
	| DrugBank = BTD00088
	| C = 49 | H = 66 | N = 10 | O = 10 | S = 2
	| molecular_weight = 1019.24 g/mol
	| bioavailability = 100%; ]: 60% to 63% of subcutaneous dose
	| protein_bound = 65%
	| metabolism = ]
	| elimination_half-life = 1.7–1.9 hours
	| pregnancy_US = B
	| legal_status = Rx
	| routes_of_administration = ], ], ]
	}}
	'''Octreotide''' (brand names '''Sandostatin''', ], and '''Octreo''', ]) is an ] that mimics natural ] pharmacologically, though it is a more potent inhibitor of ], ], and ] than the natural hormone. It was first synthesized in 1979 by the chemist Wilfried Bauer.
			<!-- Clinical data -->
	==Uses==
			| pronounce =
	===Approved uses===
			| tradename = Sandostatin, Bynfezia Pen, Mycapssa, others
	The ] (FDA) has approved the usage of a salt form of this peptide, ''octreotide ]'', as an <!-- should work on marking up "depot" or "injectable depot" and "formulation" either to wikipedia or wiktionary --> injectable depot formulation for the treatment of ], the treatment of ] and ] episodes associated with ], and treatment of diarrhoea in patients with ]-secreting tumors (]s).
			| Drugs.com = {{drugs.com|monograph|octreotide-acetate}}
			| MedlinePlus = a693049
			| DailyMedID = Octreotide
			| pregnancy_AU = C
			| pregnancy_AU_comment =
			| pregnancy_category =
			| routes_of_administration = ], ], ], ]
			| class =
			| ATC_prefix = H01
			| ATC_suffix = CB02
			| ATC_supplemental =
			<!-- Legal status -->
	===Radiolabelling===
			| legal_AU = S4
	{{See|Octreotide scan}}
			| legal_AU_comment =
	Octreotide is used in ] by labelling with ] (Octreoscan) to non-invasively image neuroendocrine and other tumours expressing somatostatin-receptors.<ref></ref> More recently, it has been radiolabelled with ] enabling imaging with ] (PET) which provides higher resolution and sensitivity.
			| legal_BR = <!-- OTC, A1, A2, A3, B1, B2, C1, C2, C3, C4, C5, D1, D2, E, F-->
			| legal_BR_comment =
			| legal_CA = Rx-only
			| legal_CA_comment =
			| legal_DE = <!-- Anlage I, II, III or Unscheduled-->
			| legal_DE_comment =
			| legal_NZ = <!-- Class A, B, C -->
			| legal_NZ_comment =
			| legal_UK = POM
			| legal_UK_comment =
			| legal_US = Rx-only
			| legal_US_comment = <ref name="Sandostatin label" /><ref name="Bynfezia Pen label" /><ref name="Mycapssa FDA label">{{cite web | title=Mycapssa- octreotide capsule, delayed release | website=DailyMed | date=21 August 2024 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58d80bc6-bdfb-4908-93e7-aace447c8d1a | access-date=30 September 2024}}</ref>
			| legal_EU = Rx-only
			| legal_EU_comment = <ref name="Mycapssa EPAR">{{cite web | title=Mycapssa EPAR | website=European Medicines Agency | date=14 September 2022 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/mycapssa | access-date=24 December 2022 }} Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</ref>
			| legal_UN = <!-- N I, II, III, IV / P I, II, III, IV-->
			| legal_UN_comment =
			| legal_status = <!--For countries not listed above-->
			<!-- Pharmacokinetic data -->
	Octreotide can also be labelled with a variety of radionuclides, such as ] or ], to enable ] (PRRT) for the treatment of unresectable neuroendocrine tumours.
			| bioavailability = 60% (]), 100% (])
			| protein_bound = 40–65%
			| metabolism = ]
			| metabolites =
			| onset =
			| elimination_half-life = 1.7–1.9 hours
			| duration_of_action =
			| excretion = Urine (32%)
			<!-- Identifiers -->
	===Off-label and experimental uses===
			| index2_label = as acetate
	Octreotide has also been used ] for the treatment of severe, refractory diarrhea from other causes. It is used in toxicology for the treatment of prolonged recurrent hypoglycemia after ] and possibly meglitinides overdose.
			| CAS_number_Ref = {{cascite|correct|??}}
			| CAS_number = 83150-76-9
			| CAS_number2 = 79517-01-4
			| CAS_supplemental = <br />{{CAS|135467-16-2}} (])
			| PubChem = Octreotide
			| PubChem2 = 448601
			| IUPHAR_ligand = 2055
			| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
			| DrugBank = DB00104
			| DrugBank2 = DBSALT000130
			| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}}
			| ChemSpiderID = 395352
			| ChemSpiderID2 = 5293182
			| UNII_Ref = {{fdacite|correct|FDA}}
			| UNII = RWM8CCW8GP
			| UNII2 = 75R0U2568I
			| KEGG_Ref = {{keggcite|changed|kegg}}
			| KEGG = D00442
			| KEGG2 = D06495
			| ChEBI_Ref =
			| ChEBI = 7726
			| ChEMBL_Ref = {{ebicite|changed|EBI}}
			| ChEMBL = 1680
			| ChEMBL2 = 1200480
			| NIAID_ChemDB =
			| PDB_ligand =
			| synonyms =
			<!-- Chemical and physical data -->
	Octreotide has also been used with varying degrees of success in infants with ] to help decrease insulin hypersecretion.
			| IUPAC_name = (4''R'',7''S'',10''S'',13''R'',16''S'',19''R'')-10-(4-aminobutyl)-19-<br /><nowiki>amino]-16-<br />benzyl-''N''--7-<br />(1-hydroxyethyl)-13-(1''H''-indol-3-ylmethyl)-6,9,12,<br />15,18-pentaoxo-1,2-dithia-5,8,11,14,17-<br />pentazacycloicosane-4-carboxamide
			| C = 49
			| H = 66
			| N = 10
			| O = 10
			| S = 2
			| SMILES = C(1C(=O)N(CSSC(C(=O)N(C(=O)N(C(=O)N(C(=O)N1)CCCCN)Cc2cc3c2cccc3)Cc4ccccc4)NC(=O)(Cc5ccccc5)N)C(=O)N(CO)(C)O)O
			| StdInChI_Ref = {{stdinchicite|changed|chemspider}}
			| StdInChI = 1S/C49H66N10O10S2/c1-28(61)39(25-60)56-48(68)41-27-71-70-26-40(57-43(63)34(51)21-30-13-5-3-6-14-30)47(67)54-37(22-31-15-7-4-8-16-31)45(65)55-38(23-32-24-52-35-18-10-9-17-33(32)35)46(66)53-36(19-11-12-20-50)44(64)59-42(29(2)62)49(69)58-41/h3-10,13-18,24,28-29,34,36-42,52,60-62H,11-12,19-23,25-27,50-51H2,1-2H3,(H,53,66)(H,54,67)(H,55,65)(H,56,68)(H,57,63)(H,58,69)(H,59,64)/t28-,29-,34-,36+,37+,38-,39-,40+,41+,42+/m1/s1
			| StdInChI_comment =
			| StdInChIKey_Ref = {{stdinchicite|changed|chemspider}}
			| StdInChIKey = DEQANNDTNATYII-OULOTJBUSA-N
			| density =
			| density_notes =
			| melting_point =
			| melting_high =
			| melting_notes =
			| boiling_point =
			| boiling_notes =
			| solubility =
			| sol_units =
			| specific_rotation =
			}}
			'''Octreotide''', sold under the brand name '''Sandostatin''' among others, is an octa] that mimics natural ] pharmacologically, though it is a more potent inhibitor of ], ], and ] than the natural hormone. It was first synthesized in 1979 and binds predominantly to the somatostatin receptors ] and ].<ref>{{cite journal | vauthors = Hofland LJ, Lamberts SW | title = Somatostatin receptors and disease: role of receptor subtypes | journal = Baillière's Clinical Endocrinology and Metabolism | volume = 10 | issue = 1 | pages = 163–176 | date = January 1996 | pmid = 8734455 | doi = 10.1016/s0950-351x(96)80362-4 | hdl-access = free | hdl = 1765/60433 | url = https://repub.eur.nl/pub/60433 }}</ref>
	In patients with suspected ], octreotide can be given to help decrease bleeding.<ref name="pmid19223890">{{cite journal |author=Abid S, Jafri W, Hamid S, ''et al.'' |title=Terlipressin vs. octreotide in bleeding esophageal varices as an adjuvant therapy with endoscopic band ligation: a randomized double-blind placebo-controlled trial |journal=Am. J. Gastroenterol. |volume=104 |issue=3 |pages=617–23 |year=2009 |month=March |pmid=19223890 |doi=10.1038/ajg.2008.147}}</ref>
			It was approved for use in the United States in 1988.<ref name="Bynfezia Pen label" /><ref name="Sandostatin label" /> Octreotide was approved for medical use in the European Union in 2022.<ref name="Mycapssa EPAR" /> {{As of|2020|6}}, octreotide is the first oral somatostatin analog (SSA) approved by the FDA.<ref name="Chiasma Mycapssa PR" /> It is on the ].<ref name="WHO23rd">{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}</ref>
	Octreotide has been investigated for patients with pain from ].<ref name="pmid10207228">{{cite journal |author=Uhl W, Anghelacopoulos SE, Friess H, Büchler MW |title=The role of octreotide and somatostatin in acute and chronic pancreatitis |journal=Digestion |volume=60 Suppl 2 |issue= |pages=23–31 |year=1999 |pmid=10207228 |doi=10.1159/000051477}}</ref>
			==Medical uses==
	It may be useful in the treatment of thymic neoplasms.{{Citation needed|date=January 2011}}
			===Tumors===
	The drug has been used off-label, injected sub-cutaneously, in the management of ] (HPOA) secondary to non-small cell lung carcinoma. Although its mechanism is not known it appears to reduce the pain associated with HPOA.{{Citation needed|date=January 2011}}
			Octreotide is used for the treatment of ] producing tumors (] and ]), when surgery is contraindicated, pituitary tumors that secrete ] (thyrotropinoma),{{citation needed|date=March 2020}} ] and ] episodes associated with ], and diarrhea in people with ]-secreting tumors (]s). Octreotide is also used in mild cases of ] when surgery is not an option.<ref>Octreotide {{Drugs.com|monograph|octreotide-acetate}}</ref><ref>{{cite journal|vauthors=Moattari AR, Cho K, Vinik AI|year=1990|title=Somatostatin analogue in treatment of coexisting glucagonoma and pancreatic pseudocyst: dissociation of responses|journal=Surgery|volume=108|issue=3|pages=581–7|pmid=2168587}}</ref>
			===Bleeding esophageal varices===
	It has been used in the treatment of malignant bowel obstruction.<ref name="pmid18490369">{{cite journal |author=Shima Y, Ohtsu A, Shirao K, Sasaki Y |title=Clinical efficacy and safety of octreotide (SMS201-995) in terminally ill Japanese cancer patients with malignant bowel obstruction |journal=Japanese journal of clinical oncology |volume=38 |issue=5 |pages=354–9 |year=2008 |month=May |pmid=18490369 |doi=10.1093/jjco/hyn035 |url=http://jjco.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18490369}}</ref>
			Octreotide is often given as an infusion for management of acute ] from ] in liver ] on the basis that it reduces ], though current evidence suggests that this effect is transient and does not improve survival.<ref name="pmid18677774">{{cite journal | vauthors = Gøtzsche PC, Hróbjartsson A | title = Somatostatin analogues for acute bleeding oesophageal varices | journal = The Cochrane Database of Systematic Reviews | issue = 3 | pages = CD000193 | date = July 2008 | volume = 2008 | pmid = 18677774 | doi = 10.1002/14651858.CD000193.pub3 | pmc = 7043291 }}</ref>
			===Radiolabeling===
	Octreotide may be used in conjunction with ] to partially reverse peripheral vasodilation in the ]. By increasing systemic vascular resistance, these drugs reduce shunting and improve renal perfusion, prolonging survival until definitive treatment with liver transplant. <ref name="pmid19238094">{{cite journal |author=Skagen C, Einstein M, Lucey MR, Said A |title=Combination Treatment With Octreotide, Midodrine, and Albumin Improves Survival in Patients With Type 1 and Type 2 Hepatorenal Syndrome. |journal=J Clin Gastroenterol. |year=2009 |month=Feb |pmid=19238094 |volume=43 |issue=7 |pages=680–5 |doi=10.1097/MCG.0b013e318188947c}}</ref>
			{{Further|Octreotide scan}}
			Octreotide is used in ] by labeling with ] (Octreoscan) to noninvasively image neuroendocrine and other tumours expressing somatostatin receptors.<ref>{{Cite web |url=https://www.medscape.com/s/viewarticle/406655_3 |title=Medscape: Octreoscan review |access-date=28 October 2010 |archive-date=12 February 2017 |archive-url=https://web.archive.org/web/20170212162120/http://www.medscape.com/viewarticle/406655_3 |url-status=live }}</ref> It has been radiolabeled with ]<ref>{{cite journal | vauthors = Chin J, Vesnaver M, Bernard-Gauthier V, Saucke-Lacelle E, Wängler B, Wängler C, Schirrmacher R | title = Direct one-step labeling of cysteine residues on peptides with methyl triflate for the synthesis of PET radiopharmaceuticals | journal = Amino Acids | volume = 45 | issue = 5 | pages = 1097–108 | date = November 2013 | pmid = 23921782 | doi = 10.1007/s00726-013-1562-5 | s2cid = 16848582 }}</ref> as well as ] (using ]), enabling imaging with ] (PET).
			===Acromegaly===
	The drug has also been shown to be effective in the treatment of ].<ref>{{cite journal |author=Dalokay Kilic, MD, Ekber Sahin, MD, Oner Gulcan, MD, Bulent Bolat, MD, Riza Turkoz, MD, Ahmet Hatipoglu, MD |title=Octreotide for Treating Chylothorax after Cardiac Surgery |journal=Texas Heart Institute Journal |volume=32 |issue=3 |pages=437–39 |year=2005 |url=http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1336729&blobtype=pdf}}</ref><ref>{{cite journal |author=Marcia L. Buck, Pharm.D., FCCP |title=Octreotide for the Management of Chylothorax in Infants and Children |journal=Pediatric Pharmacotherapy |volume=10 |issue=10 |pages= |year=2004 |url=http://www.medscape.com/viewarticle/494653}}</ref>
			In June 2020, octreotide (Mycapssa) was approved for medical use in the United States with an ] for the long-term maintenance treatment in acromegaly patients who have responded to and tolerated treatment with octreotide or ].<ref>{{cite web | title=Octreotide Capsules - Our Research | website=Chiasma | date=24 January 2020 | url=https://chiasma.com/octreotide-capsules/ | access-date=30 June 2020 | archive-date=2 July 2020 | archive-url=https://web.archive.org/web/20200702123255/https://chiasma.com/octreotide-capsules/ | url-status=dead }}</ref><ref name="Chiasma Mycapssa PR">{{cite press release | title=Chiasma Announces FDA Approval of Mycapssa (Octreotide) Capsules, the First and Only Oral Somatostatin Analog | website=Chiasma | date=26 June 2020 | url=https://ir.chiasma.com/news-releases/news-release-details/chiasma-announces-fda-approval-mycapssar-octreotide-capsules | access-date=30 June 2020 | archive-date=30 June 2020 | archive-url=https://web.archive.org/web/20200630012616/https://ir.chiasma.com/news-releases/news-release-details/chiasma-announces-fda-approval-mycapssar-octreotide-capsules | url-status=dead }}</ref> Mycapssa is the first oral somatostatin analog (SSA) approved by the FDA.<ref name="Chiasma Mycapssa PR" />
			===Hypoglycemia===
			Octreotide is also used in the treatment of refractory hypoglycemia or ] in neonates<ref>{{cite journal | vauthors = McMahon AW, Wharton GT, Thornton P, De Leon DD | title = Octreotide use and safety in infants with hyperinsulinism | journal = Pharmacoepidemiology and Drug Safety | volume = 26 | issue = 1 | pages = 26–31 | date = January 2017 | pmid = 27910218 | pmc = 5286465 | doi = 10.1002/pds.4144 }}</ref> and ]-induced hypoglycemia in adults.
	==Contraindications==		==Contraindications==
	Octreotide has not been adequately studied for the treatment of children, pregnant and lactating women. The drug is given to these groups of patients only if a ] is positive.<ref name="AustriaCodex">{{cite book|title=Austria-Codex|editor=Haberfeld, H|publisher=Österreichischer Apothekerverlag|location=Vienna|year=2009|edition=2009/2010|isbn=3-85200-196-X|language=German}}</ref><ref name="Arzneistoff-Profile">{{cite book|title=Arzneistoff-Profile|editor=Dinnendahl, V, Fricke, U|publisher=Govi Pharmazeutischer Verlag|location=Eschborn, Germany|date=2010|edition=23|volume=8|isbn=978-3-7741-98-46-3|language=German}}</ref>		Octreotide has not been adequately studied for the treatment of children as well as pregnant and lactating women. The medication is given to these groups only if a ] is positive.<ref name="AustriaCodex">{{cite book|title=Austria-Codex| veditors = Haberfeld H |publisher=Österreichischer Apothekerverlag|location=Vienna|year=2009|edition=2009/2010|isbn=978-3-85200-196-8|language=de}}</ref><ref name="Arzneistoff-Profile">{{cite book|title=Arzneistoff-Profile| veditors = Dinnendahl V, Fricke U |publisher=Govi Pharmazeutischer Verlag|location=Eschborn, Germany|year=2010|edition=23|volume=8|isbn=978-3-7741-9846-3|language=de}}</ref>
	==Adverse effects==		==Adverse effects==
	Most frequent adverse effects (more than 10% of patients) are headache, ] changes, ] reactions (including cramps, nausea/vomiting and diarrhea or constipation), ]s, ] or ], and (usually transient) injection site reactions. ], skin reactions like ], ], ], ] and ] are also fairly common (more than 1%). Rare side effects include acute ]s, ] and ]. Data on the frequency of ] vary.<ref name="AustriaCodex" /><ref name="Arzneistoff-Profile" />		The most common adverse effects are headache, ], ] changes, ] reactions (including cramps, nausea/vomiting and diarrhoea or constipation), ]s, reduction of ] release, ]<ref name="pmid20132129">{{cite journal | vauthors = Hovind P, Simonsen L, Bülow J | title = Decreased leg glucose uptake during exercise contributes to the hyperglycaemic effect of octreotide | journal = Clinical Physiology and Functional Imaging | volume = 30 | issue = 2 | pages = 141–5 | date = March 2010 | pmid = 20132129 | doi = 10.1111/j.1475-097X.2009.00917.x | s2cid = 5303108 }}</ref> or sometimes ], and (usually transient) injection site reactions. ], skin reactions such as ], ], ], ] and ] are also fairly common (more than 1%). Rare side effects include acute ]s, ] and ].<ref name="AustriaCodex" /><ref name="Arzneistoff-Profile" />
			Some studies reported ] in those who were treated by octreotide.<ref name="pmid9391775">{{cite journal | vauthors = van der Lely AJ, de Herder WW, Lamberts SW | title = A risk-benefit assessment of octreotide in the treatment of acromegaly | journal = Drug Safety | volume = 17 | issue = 5 | pages = 317–24 | date = November 1997 | pmid = 9391775 | doi = 10.2165/00002018-199717050-00004 | s2cid = 25405834 }}</ref> Rats which were treated by octreotide experienced ] in a 1998 study.<ref name="pmid9467491">{{cite journal | vauthors = Kapicioglu S, Mollamehmetoglu M, Kutlu N, Can G, Ozgur GK | title = Inhibition of penile erection in rats by a long-acting somatostatin analogue, octreotide (SMS 201-995) | journal = British Journal of Urology | volume = 81 | issue = 1 | pages = 142–5 | date = January 1998 | pmid = 9467491 | doi = 10.1046/j.1464-410x.1998.00520.x | doi-access = }}</ref>
	A prolonged ] has been observed in patients, but it is uncertain whether this is a reaction to the drug or part of the patiens' illness.<ref name="AustriaCodex" />
			A prolonged ] has been observed, but it is uncertain whether this is a reaction to the medication or the result of an existing illness.<ref name="AustriaCodex" />
	==Pharmacokinetics==
	Octreotide is absorbed quickly and completely after ] application. Maximal plasma concentration is reached after 30 minutes. The ] is 100 minutes (1.7 hours) on average when applied subcutaneously; after ], the substance is eliminated in two phases with half-lives of 10 and 90 minutes, respectively.<ref name="AustriaCodex" /><ref name="Arzneistoff-Profile" />
			== Interactions ==
	==Pharmacological effects==
			Octreotide can reduce the intestinal reabsorption of ], possibly making it necessary to increase the dose.<ref name="Arzneimittel-Interaktionen">{{cite book|title=Arzneimittel-Interaktionen | veditors = Klopp T |publisher=Arbeitsgemeinschaft für Pharmazeutische Information|year=2010|edition=2010/2011|isbn=978-3-85200-207-1|language=de}}</ref> People with ] might need less ] or ]s when treated with octreotide, as it inhibits glucagon secretion more strongly and for a longer time span than insulin secretion.<ref name="AustriaCodex" /> The ] of ] is increased;<ref name="Arzneistoff-Profile" /> besides being an ], bromocriptine is also used for the treatment of acromegaly.
			==Pharmacology==
	Since octreotide resembles somatostatin in physiological activities, it can:		Since octreotide resembles somatostatin in physiological activities, it can:
	* inhibit secretion of many hormones, such as ], ], ], ], ], ], ], ], and ]		* inhibit secretion of many hormones, such as ], ], ], ], ], ], ], ], and ],
	* reduce secretion of fluids by the intestine and ]		* reduce secretion of fluids by the intestine and ],
	* reduce gastrointestinal motility and inhibit contraction of the ]		* reduce gastrointestinal motility and inhibit contraction of the ],
	* inhibit the action of certain hormones from the ]		* inhibit the action of certain hormones from the ],
	* cause ] in the blood vessels		* cause ] in the blood vessels, and
	* reduce portal vessel pressures in bleeding varices.		* reduce portal vessel pressures in bleeding varices.
	It has also been shown to produce ] effects, most probably acting as a ] at the ].<ref>Maurer R, Gaehwiler BH, Buescher HH, Hill RC, Roemer D. Opiate antagonistic properties of an octapeptide somatostatin analog. ''Proceedings of the National Academy of Sciences USA''. 1982 Aug;79(15):4815-7. PMID 6126877</ref><ref>Allen MP, Blake JF, Bryce DK, Haggan ME, Liras S, McLean S, Segelstein BE. Design, synthesis and biological evaluation of 3-amino-3-phenylpropionamide derivatives as novel mu opioid receptor ligands. ''Bioorganic and Medicinal Chemistry Letters''. 2000 Mar 20;10(6):523-6. PMID 10741545</ref>		It has also been shown to produce ] effects, most probably acting as a ] at the ].<ref>{{cite journal | vauthors = Maurer R, Gaehwiler BH, Buescher HH, Hill RC, Roemer D | title = Opiate antagonistic properties of an octapeptide somatostatin analog | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 79 | issue = 15 | pages = 4815–7 | date = August 1982 | pmid = 6126877 | pmc = 346769 | doi = 10.1073/pnas.79.15.4815 | bibcode = 1982PNAS...79.4815M | doi-access = free }}</ref><ref>{{cite journal | vauthors = Allen MP, Blake JF, Bryce DK, Haggan ME, Liras S, McLean S, Segelstein BE | title = Design, synthesis and biological evaluation of 3-amino-3-phenylpropionamide derivatives as novel mu opioid receptor ligands | journal = Bioorganic & Medicinal Chemistry Letters | volume = 10 | issue = 6 | pages = 523–6 | date = March 2000 | pmid = 10741545 | doi = 10.1016/s0960-894x(00)00034-2 }}</ref>
			===Pharmacokinetics===
			Octreotide is absorbed quickly and completely after ] application. Maximal plasma concentration is reached after 30 minutes. The ] is 100 minutes (1.7 hours) on average when applied subcutaneously; after ], the substance is eliminated in two phases with half-lives of 10 and 90 minutes, respectively.<ref name="AustriaCodex" /><ref name="Arzneistoff-Profile" />
			==History==
			Octreotide acetate was approved for use in the United States in 1988.<ref name="Sandostatin label">{{cite web | title=Sandostatin Lar Depot- octreotide acetate kit | website=DailyMed | date=11 April 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d0b7fe9e-7000-4b79-ba3b-291ce92c14f9 | access-date=16 February 2020 | archive-date=24 March 2021 | archive-url=https://web.archive.org/web/20210324124306/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d0b7fe9e-7000-4b79-ba3b-291ce92c14f9 | url-status=live }}</ref><ref name="Bynfezia Pen label" />
			In January 2020, approval of octreotide acetate in the United States was granted to Sun Pharmaceutical under the brand name Bynfezia Pen for the treatment of:<ref name="Bynfezia Pen label">{{cite web | title=Bynfezia Pen- octreotide acetate injection | website=DailyMed | date=19 February 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=20ed4e79-ad4c-426f-859d-83790c00439b | access-date=19 April 2021 | archive-date=19 September 2022 | archive-url=https://web.archive.org/web/20220919055039/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=20ed4e79-ad4c-426f-859d-83790c00439b | url-status=live }}</ref><ref name="Bynfezia Pen letter">{{cite web | url=https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2020/213224Orig1s000ltr.pdf | title=Bynfezia Pen letter | publisher=U.S. ] (FDA) | date=28 January 2020 | access-date=16 February 2020 | archive-date=17 February 2020 | archive-url=https://web.archive.org/web/20200217070012/https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2020/213224Orig1s000ltr.pdf | url-status=live }} {{PD-notice}}</ref><ref>{{cite web | title=Drug Approval Package: Bynfezia | website=U.S. ] (FDA) | date=1 June 2020 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213224Orig1s000TOC.cfm | access-date=18 April 2021 | archive-date=30 March 2021 | archive-url=https://web.archive.org/web/20210330152034/https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213224Orig1s000TOC.cfm | url-status=live }}</ref>
			* the reduction of ] and ] (somatomedin C) in adults with ] who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and ] at maximally tolerated doses
			* severe diarrhea/flushing episodes associated with metastatic carcinoid tumors in adults
			* profuse watery diarrhea associated with ] (VIPomas) in adults
			== Society and culture ==
			=== Legal status ===
			In September 2022, the ] of the ] adopted a positive opinion, recommending the granting of a marketing authorization for the medicinal product Mycapssa, intended for the treatment of adults with acromegaly.<ref name="Mycapssa: Pending EC decision" /> The applicant for this medicinal product is Amryt Pharmaceuticals DAC.<ref name="Mycapssa: Pending EC decision">{{cite web | title=Mycapssa: Pending EC decision | website=European Medicines Agency | date=16 September 2022 | url=https://www.ema.europa.eu/en/medicines/human/summaries-opinion/mycapssa | access-date=18 September 2022 | archive-date=19 September 2022 | archive-url=https://web.archive.org/web/20220919032025/https://www.ema.europa.eu/en/medicines/human/summaries-opinion/mycapssa | url-status=dead }} Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</ref> Mycapssa was approved for medical use in the European Union in December 2022.<ref name="Mycapssa EPAR" /><ref>{{cite web | title=Mycapssa Product information | website=Union Register of medicinal products | url=https://ec.europa.eu/health/documents/community-register/html/h1690.htm | access-date=3 March 2023}}</ref>
			==Research==
			Octreotide has also been used ] for the treatment of severe, refractory diarrhea from other causes. It is used in toxicology for the treatment of prolonged recurrent hypoglycemia after ] and possibly ] overdose. It has also been used with varying degrees of success in infants with ] to help decrease insulin hypersecretion. Several clinical trials have demonstrated the effect of octreotide as acute treatment (abortive agent) in ], where it has been shown that administration of subcutaneous octreotide is effective when compared with placebo.<ref>{{cite journal | vauthors = Matharu MS, Levy MJ, Meeran K, Goadsby PJ | title = Subcutaneous octreotide in cluster headache: randomized placebo-controlled double-blind crossover study | journal = Annals of Neurology | volume = 56 | issue = 4 | pages = 488–94 | date = October 2004 | pmid = 15455406 | doi = 10.1002/ana.20210 | s2cid = 23879669 }}</ref>
			Octreotide has also been investigated in people with pain from ].<ref name="pmid10207228">{{cite journal | vauthors = Uhl W, Anghelacopoulos SE, Friess H, Büchler MW | title = The role of octreotide and somatostatin in acute and chronic pancreatitis | journal = Digestion | volume = 60 | issue = 2 | pages = 23–31 | year = 1999 | pmid = 10207228 | doi = 10.1159/000051477 | s2cid = 24011709 }}</ref>
			It has been used in the treatment of malignant bowel obstruction.<ref name="pmid18490369">{{cite journal | vauthors = Shima Y, Ohtsu A, Shirao K, Sasaki Y | title = Clinical efficacy and safety of octreotide (SMS201-995) in terminally ill Japanese cancer patients with malignant bowel obstruction | journal = Japanese Journal of Clinical Oncology | volume = 38 | issue = 5 | pages = 354–9 | date = May 2008 | pmid = 18490369 | doi = 10.1093/jjco/hyn035 | doi-access = free }}</ref>
			Octreotide may be used in conjunction with ] to partially reverse peripheral vasodilation in the ]. By increasing systemic vascular resistance, these medications reduce shunting and improve renal perfusion, prolonging survival until definitive treatment with liver transplant.<ref name="pmid19238094">{{cite journal | vauthors = Skagen C, Einstein M, Lucey MR, Said A | title = Combination treatment with octreotide, midodrine, and albumin improves survival in patients with type 1 and type 2 hepatorenal syndrome | journal = Journal of Clinical Gastroenterology | volume = 43 | issue = 7 | pages = 680–5 | date = August 2009 | pmid = 19238094 | doi = 10.1097/MCG.0b013e318188947c | s2cid = 19747120 }}</ref> Similarly, octreotide can be used to treat refractory ].<ref name="patient.info">{{cite web | vauthors = Tidy C | veditors = Cox J | work = Patient.info |title=Hypotension |date=February 2013 |url=https://patient.info/doctor/hypotension |access-date=26 June 2015 |archive-date=28 August 2021 |archive-url=https://web.archive.org/web/20210828194146/https://patient.info/doctor/hypotension |url-status=live }}</ref>{{Unreliable medical source|date=September 2024}}
			While successful treatment has been demonstrated in case reports,<ref name="pmid16392238">{{cite journal | vauthors = Kilic D, Sahin E, Gulcan O, Bolat B, Turkoz R, Hatipoglu A | title = Octreotide for treating chylothorax after cardiac surgery | journal = Texas Heart Institute Journal | volume = 32 | issue = 3 | pages = 437–9 | year = 2005 | pmid = 16392238 | pmc = 1336729 }}</ref><ref name="pmid16487393">{{cite journal | vauthors = Siu SL, Lam DS | title = Spontaneous neonatal chylothorax treated with octreotide | journal = Journal of Paediatrics and Child Health | volume = 42 | issue = 1–2 | pages = 65–7 | year = 2006 | pmid = 16487393 | doi = 10.1111/j.1440-1754.2006.00788.x | s2cid = 24561126 }}</ref> larger studies have failed to demonstrate efficacy in treating ].<ref name="pmid16242470">{{cite journal | vauthors = Chan EH, Russell JL, Williams WG, Van Arsdell GS, Coles JG, McCrindle BW | title = Postoperative chylothorax after cardiothoracic surgery in children | journal = The Annals of Thoracic Surgery | volume = 80 | issue = 5 | pages = 1864–70 | date = November 2005 | pmid = 16242470 | doi = 10.1016/j.athoracsur.2005.04.048 }}</ref>
			A small study has shown{{when|date=February 2020}} that octreotide may be effective in the treatment of ].<ref>{{cite web | title=Intracranial Hypertension Research Foundation | website=ihrfoundation.org | date=17 May 2011 | url=http://ihrfoundation.org/intracranial/hypertension/info/C172 | archive-url=https://web.archive.org/web/20101219053757/http://ihrfoundation.org/intracranial/hypertension/info/C172 | archive-date=19 December 2010 | url-status=dead | access-date=30 September 2024}}</ref>{{Unreliable medical source|date=September 2024}}<ref name="pmid17700925">{{cite journal | vauthors = Panagopoulos GN, Deftereos SN, Tagaris GA, Gryllia M, Kounadi T, Karamani O, Panagiotidis D, Koutiola-Pappa E, Karageorgiou CE, Piadites G | display-authors = 6 | title = Octreotide: a therapeutic option for idiopathic intracranial hypertension | journal = Neurology, Neurophysiology, and Neuroscience | pages = 1 | date = July 2007 | pmid = 17700925 }}</ref>
	==Interactions==		=== Obesity ===
			Octreotide has been used experimentally to treat ], particularly obesity caused by lesions in the hunger and satiety centers of the ], a region of the brain central to the regulation of food intake and energy expenditure.<ref name=Lustig2003>{{cite journal | vauthors = Lustig RH, Hinds PS, Ringwald-Smith K, Christensen RK, Kaste SC, Schreiber RE, Rai SN, Lensing SY, Wu S, Xiong X | display-authors = 6 | title = Octreotide therapy of pediatric hypothalamic obesity: a double-blind, placebo-controlled trial | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 88 | issue = 6 | pages = 2586–92 | date = June 2003 | pmid = 12788859 | doi = 10.1210/jc.2002-030003 | doi-access = free }}</ref> The circuit begins with an area of the hypothalamus, the ], that has outputs to the ] (LH) and ] (VMH), the brain's feeding and satiety centers, respectively.<ref name="flier">{{cite journal | vauthors = Flier JS | title = Obesity wars: molecular progress confronts an expanding epidemic | journal = Cell | volume = 116 | issue = 2 | pages = 337–50 | date = January 2004 | pmid = 14744442 | doi = 10.1016/S0092-8674(03)01081-X | doi-access = free }}</ref><ref>{{cite book | vauthors = Boulpaep EL, Boron WF |title=Medical physiologya: A cellular and molecular approach |publisher=Saunders |location=Philadelphia |year=2003 |page=1227 |isbn=978-0-7216-3256-8}}</ref> The ventromedial hypothalamus is sometimes injured by ongoing treatment for ] or surgery or radiation to treat ] tumors.<ref name=Lustig2003 /> With the ventromedial hypothalamus disabled and no longer responding to peripheral energy balance signals, "Efferent sympathetic activity drops, resulting in malaise and reduced energy expenditure, and ] activity increases, resulting in increased ] secretion and ]."<ref name=Lustig2011>{{cite journal | vauthors = Lustig RH | title = Hypothalamic obesity after craniopharyngioma: mechanisms, diagnosis, and treatment | journal = Frontiers in Endocrinology | volume = 2 | pages = 60 | year = 2011 | pmid = 22654817 | pmc = 3356006 | doi = 10.3389/fendo.2011.00060 | doi-access = free }}</ref> "VMH dysfunction promotes excessive caloric intake and decreased caloric expenditure, leading to continuous and unrelenting weight gain. Attempts at caloric restriction or pharmacotherapy with adrenergic or serotonergic agents have previously met with little or only brief success in treating this syndrome."<ref name=Lustig2003 /> In this context, octreotide suppresses the excessive release of insulin and may increase its action, thereby inhibiting excessive adipose storage. In a small ] in eighteen pediatric subjects with intractable weight gain following therapy for acute lymphoblastic leukemia or brain tumors and other evidence of hypothalamic dysfunction, octreotide reduced ] (BMI) and insulin response during ], while increasing parent-reported physical activity and ] (QoL) relative to ].<ref name=Lustig2003 /> In a separate placebo-controlled trial of obese adults without known hypothalamic lesions, obese subjects who received long-acting octreotide lost weight and reduced their BMI compared to subjects receiving placebo; post hoc analysis suggested greater effects in participants receiving the higher dose of the medication, and among "] subjects having insulin secretion greater than the median of the cohort." "There were no statistically significant changes in QoL scores, body fat, leptin concentration, ], or macronutrient intake", although subjects taking octreotide had higher blood glucose after a glucose tolerance test than those receiving placebo.<ref name=Lustig2006>{{cite journal | vauthors = Lustig RH, Greenway F, Velasquez-Mieyer P, Heimburger D, Schumacher D, Smith D, Smith W, Soler N, Warsi G, Berg W, Maloney J, Benedetto J, Zhu W, Hohneker J | display-authors = 6 | title = A multicenter, randomized, double-blind, placebo-controlled, dose-finding trial of a long-acting formulation of octreotide in promoting weight loss in obese adults with insulin hypersecretion | journal = International Journal of Obesity | volume = 30 | issue = 2 | pages = 331–41 | date = February 2006 | pmid = 16158082 | pmc = 1540404 | doi = 10.1038/sj.ijo.0803074 }}</ref>
	Octreotide can reduce the intestinal resorption of ], possibly making it necessary to increase the dose.<ref name="Arzneimittel-Interaktionen">{{cite book|title=Arzneimittel-Interaktionen|editor=Klopp, T|publisher=Arbeitsgemeinschaft für Pharmazeutische Information|date=2010|edition=2010/2011|isbn=978-3-85200-207-1|language=German}}</ref> Patients with ] might need less ] or ]s when treated with octreotide. The ] of ], is increased.<ref name="Arzneistoff-Profile" /> Bromocriptine, besides being an ], is also used for the treatment of acromegaly.
	==References==		== References ==
	{{reflist|2}}		{{Reflist}}
			{{GH/IGF-1 axis signaling modulators}}
	{{Pituitary and hypothalamic hormones and analogues}}
			{{Opioid receptor modulators}}
	{{Opioids}}
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