Symptomatic control & reduction of GH & IGF-1 plasma levels in patients w/ acromegaly who are inadequately controlled by surgery & RT. Acromegalic patients unfit or unwilling to undergo surgery, or in interim period until RT becomes fully effective. Symptomatic relief associated w/ functional gastro-entero-pancreatic (GEP) endocrine tumors eg, carcinoid tumors w/ carcinoid syndrome features, VIPomas, glucagonomas, gastrinomas/Zollinger-Ellison syndrome, insulinomas, GRFomas. Prevention of complications following pancreatic surgery. Emergency management of bleeding gastroesophageal varices in patients w/ cirrhosis.
Acromegaly Initially 0.05-0.1 mg SC every 8 or 12 hr. Max: 1.5 mg daily. GEP endocrine tumors Initially 0.05 mg SC once or bd, may be gradually increased to 0.1-0.2 mg tds. Complications following pancreatic surgery 0.1 mg SC tds for 7 consecutive days, starting operation day at least 1 hr before laparotomy. Bleeding gastroesophageal varices 25 mcg/hr for 5 days by continuous IV infusion. Cirrhotic patient w/ bleeding gastroesophageal varices Up to 50 mcg/hr for 5 days.
Not an anti-tumor therapy. CV-related events; impaired post-prandial glucose tolerance, hypoglycemia; increased risk of insulin-dependent diabetes, insulin requirement changes; local site reactions. Perform ultrasonic gallbladder exam prior to & at about 6-12 mth intervals during therapy. Monitor thyroid function during prolonged treatment; vit B12 levels in patients w/ history of vit B12 deprivation; blood glucose levels in patients treated for bleeding gastroesophageal varices. Hepatic cirrhosis. Women of childbearing potential should use effective contraception during treatment. Pregnancy. Not to be used during lactation. Childn <18 yr.
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