P / to, in / in a drip.
PC, with acromegaly - in an initial dose of 0.05-0.1 mg, at intervals of 8 or 12 hours.Further dose selection is based on monthly determinations of the concentration of growth hormone (GH) and IGF1 in the blood (GH values should be <2.5 ng / ml, and the value of IGF1 should be within the physiological norm), analysis of clinical symptoms and drug tolerability. In most patients, the optimal daily dose is 0.3 mg. Do not exceed the maximum daily dose of 1.5 mg. If after 3 months of treatment there is no sufficient reduction of growth hormone and an improvement in the clinical picture of the disease, therapy should be discontinued.
With endocrine tumors of the gastroenteropancreatic system - SC, in the initial dose of 0.05 mg, 1-2 times per day. Further, depending on the effect achieved, the effect on the concentration of hormones produced by the tumor (in the case of carcinoid tumors - the effect on the release of 5-hydroxyindoleacetic acid in the urine) and tolerability, the dose can be gradually increased to 0.1-0.2 mg 3 times a day. In some cases, a higher dose of the drug may be required. The maintenance dose should be selected individually.
If after 1 week of treatment with Octreotide-Aktavis carcinoid tumor with a maximum tolerated dose, there is not a sufficient improvement in the clinical picture of the disease,therapy should be discontinued.
With refractory diarrhea in patients with AIDS - SC, in an initial dose of 0.1 mg 3 times a day. If after 1 week of treatment the diarrhea does not stop, the dose is increased (under condition of normal tolerability) to 0.25 mg 3 times a day. If therapy is ineffective for 1 week (at a dose of 0.25 mg 3 times a day), treatment is discontinued.
To prevent complications after operations on the pancreas - Enter SC 0.1 mg 3 times a day for 7 consecutive days, starting from the day of surgery (at least 1 hour before laparotomy).
To stop bleeding from varicose veins of the esophagus - in / in the drip at a rate of 0.025 mg / h for 1-2 days. In patients with a high risk of bleeding, the infusion of the drug should be continued, but not more than 5 days. The drug Octreotide-Aktavis can be administered when diluted with saline.
In elderly patients no dose adjustment is required.
Patients with impaired hepatic function
In patients with cirrhosis of the liver T1/2 may increase, which requires dose adjustment. This does not apply to patients with fatty liver degeneration.
Patients with impaired renal function
With subcutaneous administration, a decrease in renal function does not affect the area under the "concentration-time" curve of octreotide, so there is no need for dose adjustment in this group of patients.
Octreotide acetate (active substance of the drug) is not stable in preparations for parenteral nutrition.
Application rules
With n / to the introduction
Patients who self-administer subcutaneous injection of Octreotide-Actavis should receive detailed instructions from a doctor or nurse.
For the introduction of SC injections, dilution of the drug is not required.
Avoid multiple injections in the same place at short intervals. To prevent the appearance of discomfort at the injection site, the solution should be at room temperature.
Ampoules should be opened immediately before the administration of the solution. Unused solution should be disposed of.
With iv introduction
Before administration, the solution should be inspected, it should be colorless and without visible foreign particles.
The drug Octreotide-Actavis is physically and chemically stable in sterile saline or sterile 5% aqueous dextrose (glucose) solution for 24 hours.However, in view of the fact that octreotide it may be preferable to use glucose metabolism for dilution of saline. The prepared solution is physiologically and chemically stable at a temperature below 25 ° C for 24 hours. To avoid microbial contamination, dilute solutions should be used immediately after preparation. If the solution is not used immediately after dilution, it should be stored at 2-8 ° C until it is applied. Before administration, the solution should be held at room temperature. The period including dilution of the solution, its storage in the refrigerator and the last administration to the patient, should not exceed 24 hours.
When Octreotide-Actavis is administered as an infusion, a concentration solution of 0.5 mg / ml is usually used, diluted in 60 ml of saline. Infusions are repeated at the required frequency in accordance with the recommended duration of treatment. Octreotide-Actavis can also be used in lower concentrations.