Somatostatin

Registered South African indications:

• Acute haemorrhage from oesophageal varices

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Pregnancy
• Breastfeeding
• Post-partum period

Cautions

• Renal impairment
• Hepatic impairment
• Elderly
• Insulin dependent diabetics
• Children

Forms avail. in SA and covered in this monograph: inj

Acute haemorrhage from oesophageal varices

• IV: Initial: 250μg slow IV bolus over 3-5min; Followed by continuous infusion at 250μg/hr, until bleeding stops (usually within 12-24hrs); Once bleeding stops it is recommended infusion is continued for at least another 48-72hrs; Max duration: 120hrs

If the infusion is interrupted for any reason, a second bolus dose may be given

Reconstitute in 0.9% normal saline or 5% dextrose to a concentration of 250μg/ml

Once reconstituted use within 24hrs and protect from light

Not established for use in children

Pregnancy

• Contraindicated
• Somatostatin is contraindicated during pregnancy and the immediate post-partum period (puerperium). There is no evidence of the drug’s safety in human pregnancy nor is there evidence from animal work that is free from hazard
• Avoid during pregnancy unless there is no safer alternative (to be approved by a specialist)

Breastfeeding 

• Contraindicated 
• Somatostatin is contraindicated during breastfeeding. There is no evidence of the drug’s safety in human breastfeeding, nor is there evidence from animal work that is free from hazard
• Avoid during breastfeeding unless there is no safer alternative (to be approved by a specialist)

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no information available

Elderly

• Caution; no information available

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Gastrointestinal Disorders

• Nausea and vomiting

Endocrine and Metabolic Disorders

• Flushing

Sensory Disorders

• Vertigo

Barbiturates

None routine. Specific cases may require

• Blood glucose 
• Renal function

Pharmacokinetics
- Elimination half-life (t_1/2):

• 1,1 and 3 minutes in normal subjects;
• 1,2 and 4,8 minutes in subjects with liver disease;
• 2,6 and 4,9 minutes in subjects with chronic renal failure

Somatostatin is a synthetic cyclic 14 amino acid peptide (identical in structure and activity to naturally occurring somatostatin), which decreases splanchnic blood flow and portal venous pressure in man. Somatostatin has been demonstrated to decrease splanchnic blood flow and portal venous pressure.

Injection 3mg

• Stilamin (Omnimed) originator