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Endocrine (other)

Octreotide

Also called Sandostatin, Sandostatin LAR Depot, Mycapssa (oral)

Octreotide is a long-acting, man-made version of somatostatin, the body's 'off switch' for many hormones. It treats acromegaly (too much growth hormone) and the severe diarrhea and flushing caused by certain hormone-making tumors. It comes as a short-acting shot, a monthly depot shot, and an oral capsule.

FDA-approvedApproved by the FDA for at least one use after large human trials.

All printable flashcards

Drawn from its published sequence: 8 residues, one bead each. Dashed arcs are ring bonds.

Overview

Octreotide is a long-acting, man-made version of somatostatin, the body's 'off switch' for many hormones. It treats acromegaly (too much growth hormone) and the severe diarrhea and flushing caused by certain hormone-making tumors. It comes as a short-acting shot, a monthly depot shot, and an oral capsule.

How it works

Established: octreotide binds somatostatin receptors and suppresses release of growth hormone, IGF-1 (indirectly), insulin, glucagon, and gut hormones such as serotonin and VIP. Reducing these hormones controls acromegaly and tumor-related diarrhea and flushing; the label notes it has not been shown to shrink carcinoid tumors or VIPomas.

What research shows

  • In acromegaly studies, GI effects (diarrhea, loose stools, nausea, abdominal discomfort) occurred in 34–61%, and gallbladder abnormalities in 63% (gallstones 27%) (FDA label).

Doses studied in people

Study or labelDose usedSource
FDA label, acromegaly (Sandostatin Injection)Start 50 mcg subcutaneously three times daily; usual 100 mcg three times daily1
FDA label, carcinoid tumors100–600 mcg/day in 2–4 divided doses initially1
FDA label, VIPomas200–300 mcg/day in 2–4 divided doses initially1
FDA label, Sandostatin LAR Depot20 mg intragluteally every 4 weeks, adjusted within 10–40 mg (acromegaly) or 10–30 mg (tumors)2

Label doses shown.

Read this first: these are the amounts given to participants in published studies or written on official prescribing labels, reported for reference. They are not recommendations. Trial doses were chosen for specific patients under medical supervision, and a dose that is safe in one person can be harmful in another.

Weekly protocol

How the schedule looks week by week. Each chart says where it comes from: a prescribing label, a clinical trial, or a protocol commonly reported online.

Sandostatin LAR Depot: acromegaly

Prescribing label

One week

D1D2D3D4D5D6D7

Three times daily during lead-in, then once every 4 weeks · Subcutaneous lead-in, then intragluteal intramuscular depot

Dose by week

Sandostatin injection 50 mcg three times dailyLead-in · wk 1–2
20 mg LAR every 4 weekswk 3–14
10–40 mg LAR every 4 weeksMaintenance · wk 15+
Course
Ongoing
Note
The lead-in lasts at least 2 weeks to check tolerance. After 3 months on 20 mg, the dose is adjusted by GH, IGF-1 and symptoms; doses above 40 mg are not recommended.
Source
SANDOSTATIN LAR DEPOT prescribing information (FDA, revised 07/2024)

Sandostatin Injection: acromegaly

Prescribing label

One week

D1D2D3D4D5D6D7

Three times daily · Subcutaneous injection

Dose by week

50 mcg three times dailyStarting · wk 1–2
Usually 100 mcg three times dailyMaintenance · wk 3+
Course
Ongoing
Note
Titration is guided by IGF-1 (can be checked every 2 weeks). Up to 500 mcg three times daily is allowed, but doses above 300 mcg/day seldom add benefit.
Source
SANDOSTATIN (octreotide) Injection prescribing information (FDA, 05/2021)

Reference only, not a recommendation. Label and trial schedules were set for specific patients under medical supervision. Use the calculator only to understand the arithmetic.

Safety

  • Gallstones and gallbladder complications (label).
  • Slow heart rate, conduction abnormalities and arrhythmias; AV block mainly with high-dose IV use (label).
  • Low or high blood sugar, hypothyroidism, pancreatitis, fat malabsorption and low vitamin B12 (label).
  • Common: diarrhea, nausea, abdominal discomfort, injection-site pain, headache (label).

Report side effects of any drug or product to the FDA through MedWatch. For a possible poisoning in the US, call Poison Control at 1-800-222-1222.

Storage and stability

Ampuls refrigerated at 2–8°C and protected from light; stable 14 days at room temperature if protected from light (label).

General lab handling, not instructions for personal use. See Storage and stability.

History

Marketed by Novartis; first US approval 1988 as Sandostatin, followed by the monthly intramuscular Sandostatin LAR Depot. An oral delayed-release capsule (Mycapssa) was approved June 26, 2020 for long-term acromegaly maintenance.

Common questions

Is octreotide FDA-approved?

Yes. It is approved as Sandostatin injection, a monthly depot shot (Sandostatin LAR Depot) and oral Mycapssa capsules for acromegaly 123.

What is octreotide used for?

It mimics somatostatin and lowers growth hormone and certain gut hormones 1. This controls acromegaly and the diarrhea and flushing from some tumors, though the label says it has not been shown to shrink them 1.

What doses are on the FDA labels?

For acromegaly, the injection label starts at 50 mcg three times daily, usually 100 mcg 1. The depot label lists 20 mg into the buttock muscle every 4 weeks 2. These are label figures, not advice.

What are the main side effects?

In acromegaly studies, stomach effects such as diarrhea and nausea affected 34% to 61%, and gallstones 27% 1. The label also warns of slow heart rate, blood sugar changes and low thyroid function 1.

How is octreotide injection stored?

Ampuls are refrigerated at 2 to 8°C and protected from light, and stay stable for 14 days at room temperature if kept from light 1.

Is octreotide banned in sport?

It is not named on WADA's 2026 Prohibited List 4.

Related compounds

Endocrine (other)FDA-approvedFlashcard

Desmopressin

DDAVP · dDAVP

Desmopressin is a modified version of the body's water-saving hormone, vasopressin.

GastrointestinalFDA-approvedFlashcard

Linaclotide

Linzess · Constella

Linaclotide is a small peptide pill that works inside the gut to treat chronic constipation and constipation-type irritable bowel syndrome.

Sources

  1. SANDOSTATIN (octreotide acetate) Injection prescribing information FDA label
  2. SANDOSTATIN LAR DEPOT prescribing information (2024) FDA label
  3. MYCAPSSA (octreotide) approval package, NDA 208232 Regulatory
  4. WADA 2026 Prohibited List Regulatory

Last reviewed 2026-10-25 · How we research · Found an error? See our corrections policy.