What Is Octreotide?

Octreotide is a synthetic version of somatostatin, a hormone your body naturally produces to regulate growth hormone and digestive functions.

Sold under brand names like Sandostatin, Sandostatin LAR Depot, and Mycapssa, Octreotide belongs to the somatostatin analog drug class. It's manufactured by Novartis (Sandostatin/Sandostatin LAR), Amryt Pharma (Mycapssa), and several generic manufacturers including Teva, Avet, Fresenius Kabi, Hikma, and Sagent.

Octreotide is not a controlled substance. Generic versions are available for both the immediate-release injection and, as of October 2024, the long-acting release (LAR) injection (manufactured by Teva).

What Is Octreotide Used For?

Octreotide is FDA-approved for several conditions:

Acromegaly

Acromegaly is a hormonal disorder caused by excess growth hormone, usually from a pituitary tumor. Octreotide reduces growth hormone and IGF-1 levels in patients who haven't responded adequately to surgery or radiation, or who can't have those treatments.

Carcinoid Syndrome

Patients with metastatic carcinoid tumors often experience severe diarrhea and flushing episodes. Octreotide manages these symptoms by suppressing the hormones that cause them.

VIPomas

VIPomas are rare tumors that produce excess vasoactive intestinal peptide (VIP), causing profuse watery diarrhea. Octreotide controls the diarrhea by inhibiting VIP release.

Off-Label Uses

Doctors also prescribe Octreotide off-label for a range of conditions, including:

• Gastroenteropancreatic neuroendocrine tumors (GEP-NETs)
• Esophageal variceal bleeding
• Hepatorenal syndrome
• Refractory diarrhea (from chemotherapy, AIDS, or graft-versus-host disease)
• Dumping syndrome after gastrectomy
• Congenital hyperinsulinism
• Small intestinal fistulas
• Prevention of carcinoid crisis during surgery

For details on how Octreotide works in your body, check out our mechanism of action explainer.

How Is Octreotide Taken?

Octreotide comes in several formulations, each suited to different situations:

Immediate-Release Subcutaneous Injection

This is the short-acting form, available in multiple strengths (50, 100, 200, 500, and 1,000 mcg/mL). Patients typically self-administer injections 2 to 4 times daily, between meals and at bedtime. Starting dose for acromegaly is usually 50 mcg three times daily. For carcinoid tumors, doses range from 100 to 600 mcg per day.

Long-Acting Release (LAR) Intramuscular Injection

Sandostatin LAR Depot (and its generic equivalent) is given as a deep gluteal intramuscular injection once every 4 weeks. Available in 10 mg, 20 mg, and 30 mg kits. This must be administered by a healthcare professional — it's not a self-injection.

Patients usually start on immediate-release Octreotide to make sure they tolerate it, then switch to LAR for convenience.

Oral Capsules (Mycapssa)

Mycapssa is the newest option — delayed-release oral capsules for patients who've already responded to injectable Octreotide or Lanreotide. The typical dose is 20 mg twice daily, taken on an empty stomach (at least 1 hour before or 2 hours after a meal). Doses can be increased up to 40 mg twice daily.

Who Should Not Take Octreotide?

Octreotide is contraindicated in patients with a known hypersensitivity to Octreotide or any component of the formulation.

Caution is needed in several situations:

• Diabetes — Octreotide affects insulin and glucagon secretion, which can cause blood sugar swings. Diabetic patients may need dose adjustments to their diabetes medications.
• Heart conditions — Octreotide can cause bradycardia (slow heart rate). Patients on beta-blockers or calcium channel blockers should be monitored closely.
• Gallbladder disease — Long-term use increases the risk of gallstones. Patients with existing gallbladder issues should discuss this risk with their doctor.
• Pregnancy — Category B (no evidence of fetal harm in animal studies, but limited human data). Use only if clearly needed.
• Breastfeeding — Octreotide passes into breast milk at levels similar to blood concentrations.

Always tell your doctor about all medications you take. Octreotide has important drug interactions, including with Cyclosporine, insulin, beta-blockers, and Bromocriptine.

How Much Does Octreotide Cost?

Octreotide pricing varies dramatically depending on the formulation:

• Generic immediate-release injection: Approximately $40–$110 for 10 vials (100 mcg/mL) with a coupon
• Generic LAR (Teva): Approximately $3,000–$5,500 per monthly injection
• Sandostatin LAR Depot (brand): $6,700–$8,500 per monthly injection
• Mycapssa oral capsules: Approximately $8,000–$10,000 per month

Most insurance plans cover Octreotide but typically require prior authorization. Many plans also require step therapy — starting with generic immediate-release Octreotide before approving LAR or brand formulations. Specialty pharmacy distribution is usually required for LAR and Mycapssa.

There are ways to lower your costs:

• Novartis copay card — Covers up to $15,000 per year in copays for commercially insured Sandostatin LAR patients
• Patient assistance programs — Novartis Patient Assistance Foundation provides free Sandostatin to eligible uninsured/underinsured patients
• Foundation support — PAN Foundation and HealthWell Foundation may offer copay assistance for neuroendocrine tumor or acromegaly patients

For a complete guide to savings, read our post on how to save money on Octreotide.

Final Thoughts

Octreotide is a critical medication for patients with acromegaly, carcinoid syndrome, VIPomas, and various other conditions where hormone regulation is needed. With multiple formulations — from self-administered subcutaneous injections to monthly LAR shots to oral capsules — there are options to fit different lifestyles and treatment stages.

The biggest challenges are cost and availability. If you're having trouble finding Octreotide or affording it, Medfinder can help you locate pharmacies with stock and connect you with savings options.