Octreotide
Somatostatin AnalogapprovedAlso known as: Sandostatin, Sandostatin LAR, SMS 201-995
A synthetic octapeptide analog of somatostatin with prolonged activity, used to treat acromegaly, carcinoid tumors, and vasoactive intestinal peptide-secreting tumors.
Overview
Octreotide is a synthetic 8-amino acid peptide that mimics the natural hormone somatostatin but with a much longer duration of action (1.5 hours vs 2-3 minutes). It was first synthesized by Sandoz (now Novartis) and approved by the FDA in 1988. Octreotide binds preferentially to somatostatin receptor subtypes 2 and 5, inhibiting the secretion of growth hormone, insulin, glucagon, gastrin, and other GI hormones. It is available as immediate-release subcutaneous injections (Sandostatin) and as a long-acting depot formulation (Sandostatin LAR) given monthly. It is a cornerstone therapy for acromegaly, neuroendocrine tumors, and severe diarrheal conditions.
Mechanism of Action
Octreotide mimics somatostatin through multiple inhibitory actions: (1) Binds somatostatin receptors SSTR2 and SSTR5 with high affinity; (2) Inhibits GH secretion from the anterior pituitary; (3) Suppresses insulin and glucagon secretion from the pancreas; (4) Reduces splanchnic blood flow and portal pressure; (5) Inhibits GI hormone secretion (gastrin, VIP, secretin, motilin); (6) Decreases GI motility and fluid secretion; (7) In neuroendocrine tumors, directly inhibits tumor hormone secretion and may have antiproliferative effects via SSTR2-mediated apoptosis.
Molecular Formula
C49H66N10O10S2
Molecular Weight
1019.24 g/mol
Sequence
D-Phe-Cys-Phe-D-Trp-Lys-Thr-Cys-Thr-ol (cyclic disulfide)
Dosage Protocols
Dose Range
50mcg – 500mcg
Frequency
Three times daily (SC) or monthly (LAR)
Route
subcutaneous / intramuscular
Cycle Length
Ongoing
SC: Start 50mcg TID, titrate based on GH/IGF-1 levels. LAR: 20mg IM monthly, adjustable to 10-40mg. Switch to LAR after SC dose stabilization.
Source: FDA prescribing information
🧮 Personalized Dosage Calculator
💰 Estimated Pricing
Typical Supply
20mg or 30mg LAR depot
Last Updated
2026-02
Brand Sandostatin. For acromegaly, carcinoid tumors. SC: $100-500/mo. LAR depot: $2,000-3,000/injection. Insurance critical.
⚠️ Prices are estimates based on publicly available data and may vary significantly by vendor, location, and prescription status. This is not medical or financial advice.
Side Effects
| Effect | Severity |
|---|---|
| Gallstones | moderate |
| Diarrhea / Steatorrhea | moderate |
| Abdominal pain | mild |
| Hyperglycemia | moderate |
| Injection site pain | mild |
Pros & Cons
Well-established therapy with decades of clinical use and extensive safety data
Long-acting depot (LAR) allows once-monthly dosing for chronic conditions
Highly effective for symptom control in neuroendocrine tumors and acromegaly
Can reduce tumor size in some acromegaly patients and slow NET progression
High rate of gallstone formation with long-term use (15-30%)
Can worsen glucose tolerance due to insulin suppression
Expensive, particularly the LAR depot formulation
Does not normalize IGF-1 in all acromegaly patients (~65% normalization)
Research Studies
🩸 Blood Work
No specific bloodwork requirements reported for this peptide. General health panels are always recommended before starting any peptide protocol.
Legal Status
FDA-approved (1988) for acromegaly, carcinoid tumors, and VIPomas. Prescription-only. Available in SC injection and monthly LAR depot formulation.
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