Reactions 632 - 21 Dec 1996

Octreotide

Pancreatitis: 3 case reportsThree patients developed pancreatitis following treatment

with octreotide. The first patient was a 66-year-old man with ahistory of relapsing pancreatitis. He was hospitalised withabdominal pain and a serum amylase level of 32 µkat/L(normal 0–2). Twelve hours later, when the pain haddiminished, he was treated with a single dose of SC octreotide200µg. However, within 3–4 hours, he developed the sameabdominal pain, but with increased intensity. His serumamylase level increased to 41 µkat/L and his liver function testsbecame abnormal. He was discharged after 6 days without anysymptoms and with normal laboratory results.

The second patient, a 49-year-old man also had a history ofrelapsing pancreatitis but he was hospitalised electively. At thetime he did not have any abdominal pain. It was planned thathe administer single doses of octreotide at home for attacks ofpancreatitis. In hospital, he was given SC octreotide 100 µg.Within 3–4 hours, he developed severe abdominal pain. Hisserum amylase level increased to 33 µkat/L and his liverfunction tests became abnormal. He was discharged after 4days without any symptoms and with normal laboratoryresults.

The third patient, a 51-year-old woman, was treated withoctreotide because of daily losses of fluid through herjejunostomy; she was also receiving codeine therapy.Following the first dose of octreotide 100 µg, she experiencedupper abdominal pain and her serum amylase level increasedto 18 µkat/L. Codeine was discontinued and she subsequentlytolerated further treatment with octreotide.

Author comment: ‘We suggest that this side-effect ofoctreotide should be part of the drug information foroctreotide.’ In the third patient, the concomitantadministration of octreotide and codeine probably induced thepancreatitis.Bodemer G, et al. Octreotide-induced pancreatitis: an effect of increasedcontractility of Oddi sphincter. Lancet 348: 1668-1669, 14 Dec 1996 -Sweden 800490910

1

Reactions 21 Dec 1996 No. 6320114-9954/10/0632-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved