There are isolated reports of the development of liver function (acute hepatitis without cholestasis with normalization of transaminase levels after the abolition of octreotide); slow development of hyperbilirubinemia associated with increased rates of alkaline phosphatase, gamma-glyutamiltrasferazy and, to a lesser extent, other transaminases.
On the part of the cardiovascular andriol for sale system : in some cases – bradycardia.
On the part of metabolism: as buy deca durabolin octreotide has an overwhelming influence on the formation of GH, glucagon and insulin, it can affect glucose metabolism. Possibly, impaired glucose tolerance after a meal.With prolonged use of octreotide p / c in some cases, may develop persistent hyperglycemia. There were also the state of hypoglycemia.
Other: rarely reported temporary hair loss after administration of octreotide. There are some reports about the development of hypersensitivity reactions: rare – allergic skin reactions; in some cases – anaphylactic reactions.
Doses up to 2000 mg of octreotide in the form p / injection 3 times within a few months were well tolerated. The maximum single dose in / bolus in adult patients is 1 mg.
At the same time observed symptoms such as a decrease in heart rate, “tides” of blood to the face, abdominal pain, spastic nature, diarrhea, nausea, a feeling of emptiness in the stomach. These symptoms resolved within 24 hours after drug administration.
One patient by continuous infusion dose excess octreotide was introduced in error (250 g / h instead of 25 g / h), which is not accompanied by side effects. In acute overdose there were no any life-threatening reactions. In case of overdose – Treatment is symptomatic.
INTERACTION WITH OTHER DRUG
Octreotide reduces the absorption of cyclosporine, slows down the absorption of cimetidine. With simultaneous application of octreotide and bromocriptine increases the bioavailability of the latter.
Needed correction dosing regimen simultaneously used diuretics, beta blockers, blockers “slow” calcium channels, insulin, oral hypoglycemic drugs, glucagon.
There is evidence that somatostatin analogs can reduce the metabolism of drugs metabolized by cytochrome P450 enzymes (perhaps due to suppression of growth hormone). Since it is impossible to eliminate such effects octreotide, drugs metabolized by cytochrome P450 enzyme system, and have a narrow therapeutic range of doses should be administered with caution.
When tumors of the pituitary gland, secreting GH, the need for careful monitoring of patients, since it is possible to increase the size of the development of tumors such serious complications, such as narrowing of the visual field. In these cases, you should consider the need for other treatments. In 15-30% of patients receiving octreotide n / a for a long time, may cause gallstones. The prevalence in the general population (ages 40-60 years) is 5-20%. Experience andriol for sale of prolonged treatment with octreotide prologirovannogo buy deca durabolin steps patients with acromegaly and gastrointestinal tumors and pancreatic cancer suggests that octreotide prologirovannogo action, compared with short-acting octreotide does not lead to an increase in the frequency of formation of gallstones. However, we recommend holding ultrasound of the gallbladder before starting treatment with octreotide and approximately every 6 months during treatment. Gallstones, if they still show up, usually asymptomatic. In the presence of clinical symptoms shown conservative treatment (for example, the use of bile acid drugs) or surgery.
Patients with type 1 diabetes, octreotide can influence the glucose metabolism and thus reduce the need for insulin in the feed. For patients with type 2 diabetes and patients without concomitant disorders of carbohydrate metabolism subcutaneous octreotide injections can lead to postprandial glycemia. In this connection, it is recommended to regularly monitor blood glucose levels and, if necessary, correct the hypoglycemic therapy.
Patients with insulinomas octreotide during treatment can be marked increase in the severity and duration of hypoglycemia (this is due to the overwhelming influence of more pronounced secretion of GH and glucagon than insulin secretion, as well as shorter duration of inhibition of insulin secretion). Displaying systematic monitoring of these patients.
Prior to the appointment of octreotide patients should undergo initial ultrasound gallbladder. During treatment with octreotide should be repeated ultrasound examination of the gallbladder, preferably at intervals of 6-12 months.
If the gall bladder stones are detected before the start of the treatment, it is necessary to evaluate the potential benefits of treatment with octreotide compared with the possible risk associated with the presence of gallstones.
Currently, there is no any evidence that octreotide adversely affects the course or prognosis existing gallstones.
Management of patients with gall bladder stones are formed during treatment with octreotide. a). . Asymptomatic gallstones
The use of octreotide can stop or continue – in line with the assessment of benefit / risk ratio. In any case, it does not require any action other than the continuation of the examination, making them more frequently if necessary.
. b) Gallstones symptomatic
application of octreotide can stop or continue – in line with the assessment of benefit / risk ratio. In andriol for sale any event, the patient should be treated the same as in other cases of cholelithiasis symptomatic. Drug treatment includes the use of combinations of drugs bile acids (e.g., chenodeoxycholic acid at a dose of 7.5 mg / kg / day in combination with ursodeoxycholic acid at the same dose.) Under ultrasound guidance – until complete disappearance of the stones.
Effects on ability to drive buy deca durabolin vehicles and management mechanisms
is not available on the effect of octreotide data on the ability to drive and use machines.