Long-acting synthetic octapeptide analogue of somatostatin useful in the control of sulfonylurea-induced hypoglycaemia (BSL <4 mol/L) either from overdose or an iatrogenic source. It is also useful in hypoglycaemia induced from Quinine.
- Administer 50 micrograms IV, then…..
- Commence an infusion at 25 micrograms/hour. Dilute 500 micrograms of octreotide in 500ml of 0.9% saline and infuse at 25 ml/hour
- Alternatively give 100 micrograms SC or IM every 6 hours, although break through hypoglycaemia may occur.
- Euglycaemia is usually maintained while on the infusion but if it dose occur correct with 50% dextrose and double the infusion rate.
- Euglycaemia needs to be maintained for 12 hours off an infusion before the patient is medically cleared
- Paediatric doses = 1 microgram/kg as a bolus IV of SC and also 1 microgram/kg/hour as an infusion IV.
- Boyle PJ, Justice K, Krentz AJ et al. Octreotide reverses hyperinsulinemia and prevents hypoglycemia induced by sulfonylurea overdoses. Journal of Clinical Endocrinology and Metabolism 1993; 77:752-756.
- Fasano CJ, O’Malley G, Dominici P et al. Comparison of octreotide and standard therapy versus standard therapy alone for the treatment of sulfonylurea-induced hypoglycemia. Annals of Emergency Medicine 2008; 51:400-406.
- McLaughlin SA, Crandall CS, McKinney PE. Octreotide: an antidote for sulfonylurea-induced hypoglycemia. Annals of Emergency Medicine 2000; 36:133-138.