Octreotide Arrow (Octreotide Acetate)

Octreotide Arrow is a synthetic analogue of somatostatin that acts on neuroendocrine pathways. It is indicated for:

• Acromegaly: reduces growth hormone and IGF‑1 levels, helping control disease activity.
• Carcinoid syndrome: lessens flushing and diarrhoea by inhibiting serotonin release.
• VIPoma/Medullary thyroid carcinoma associated diarrhea: controls severe secretory diarrhoea.
• Preventive control of postoperative pancreatic fistula after major pancreatic surgery, where evidence supports its use.
• Management of hypoglycaemia related to insulinoma or nesidioblastosis by suppress of insulin secretion.
• Control of bleeding from varice various gastro‑intestinal bleeds where som­ som pathways are involved.

• Octreotide acetate is a synthetic somatostatin analogue that binds with high affinity to somatostatin receptor subtypes 2 and 5. Activation of these G‑protein‑coupled receptors inhibits adenylate cyclase, reduces cyclic AMP levels and suppresses the release of several hormones and peptides, including growth hormone, insulin, glucagon, gastrin and serotonin. This broad inhibition underlies its therapeutic effects in hormone‑driven disorders.

Octreotide Arrow may cause a range of adverse reactions.

Common Side Effects

• Gastrointestinal discomfort: nausea, abdominal cramping or diarrhoea.
• Injection‑site reactions: erythema, pain or induration.
• Gallbladder changes: biliary sludge or gallstones.
• Metabolic alterations: hyperglycaemia or hypoglycaemia.
• Headache or fatigue.

Serious or Rare Side Effects

• Pancreatitis.
• Severe hypersensitivity reactions, including anaphylaxis.
• Cardiac arrhythmias.
• Acute cholecystitis.
• Significant electrolyte disturbances.

Octreotide Arrow should be used with clinical oversight and consideration of patient‑specific factors.

• Renal impairment: dose adjustment may be required.
• Hepatic dysfunction: monitor liver enzymes and gallbladder status.
• Diabetes mellitus: monitor blood glucose closely, as the drug can affect glycaemic control.
• Cardiovascular disease: observe for brady‑cardia or arrhythmias.
• Pregnancy and lactation: only use if the potential benefit outweighs risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Octreotide Arrow can influence the pharmacokinetics of several co‑administered medicines.

Major Interactions (Avoid)

• Cytochrome P450 substrates metabolised by CYP3A4 (e.g., midazolam) – may have reduced exposure.
• Long‑acting octreotide formulations – risk of additive hormonal suppression.

Moderate Interactions (Monitor Closely)

• Insulin or oral hypoglycaemic agents – risk of hypoglycaemia or hyperglycaemia.
• Antiplatelet or anticoagulant drugs – potential for altered bleeding risk.
• Thyroid hormone replacement – may require dose adjustment.