Octreotide & acromegaly drugs
also: somatostatin analogue · octreotide · lanreotide · pegvisomant · acromegaly
Overview
Somatostatin analogues suppress growth hormone (acromegaly) and have several other high-yield uses (variceal bleeding, carcinoid). Dopamine agonists/GH antagonists complete the acromegaly toolkit.
Mechanism
Octreotide/lanreotide are somatostatin analogues → inhibit GH (and many gut hormones) secretion. Pegvisomant is a GH-receptor antagonist. Dopamine agonists (cabergoline) modestly lower GH (and are first-line for prolactinoma — cross-ref).
Indications
- Acromegaly (after/instead of surgery)
- Variceal/GI bleeding (octreotide/terlipressin — cross-ref GI)
- Carcinoid syndrome / neuroendocrine tumours
The agents
SC/depot
Acromegaly; also acute variceal bleeding and carcinoid.
SC
Acromegaly resistant to somatostatin analogues.
oral
Cross-references the prolactinoma/dopamine-agonist card.
Adverse effects
Inhibits gallbladder contraction.
Cautions & contraindications
Specialist-initiated; monitor gallbladder + glucose.
Interactions
- Alters glucose control (adjust antidiabetics)
Monitoring & kinetics
IGF-1/GH response; gallbladder USS; glucose
SC or depot injection. (Definitive acromegaly treatment is trans-sphenoidal surgery.)
Choosing it
true
Source: BNF — Somatostatin analogues