Somatostatin

What it is and how it works

Somatostatin is a natural tetradecapeptide that inhibits release of growth hormone, insulin, glucagon, gastrin and other gastrointestinal hormones and reduces gastric, pancreatic and intestinal secretions. It reduces splanchnic blood flow and portal venous pressure; its half-life is only a few minutes, so it is given by continuous infusion.

Indications

Acute bleeding from oesophageal varices (adjunct to endoscopic therapy); adjunct in the management of pancreatic, biliary and intestinal fistulas; prophylaxis of complications after pancreatic surgery in some countries.

Dosage and administration (summary)

Given by intravenous injection of 250 micrograms over 3–5 minutes followed by a continuous infusion of 250 micrograms/hour (about 3.5 micrograms/kg/hour), usually for several days according to indication.

Contraindications

Hypersensitivity to somatostatin; peripartum period and pregnancy.

Warnings and precautions

Causes initial hypoglycaemia followed by hyperglycaemia, so monitor blood glucose every few hours, particularly in diabetics. Avoid interruption of the infusion and rapid bolus injection, which may cause flushing, nausea and bradycardia.

Pregnancy

Should not be used in pregnancy or the peripartum period.

Storage and supply

Store below 25 °C; after reconstitution, use promptly.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.