Octreotide
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Reactions 799 - 29 Apr 2000 S Octreotide Hypertension: case report A 26-year-old woman with type 1 diabetes mellitus and severe autonomic dysfunction developed severe hypertension after receiving the long-acting formulation of octreotide ‘Sandostatin LAR’ for diabetic diarrhoea. The woman had a 16-year history of diabetes mellitus, complicated by severe diabetic autonomic neuropathy, background retinopathy and diabetic nephropathy. Due to her autonomic dysfunction, she had episodes of orthostatic hypotension and a 9-year history of severe diarrhoea. Her diarrhoea had been managed successfully with SC octreotide 75µg 3 times daily [duration of therapy not stated], but 1 week after the initiation of octreotide therapy she developed headaches beginning shortly after each octreotide injection and persisting for 1–2 hours. Systolic BP values during these headaches were 130–140mm Hg. For convenience, the woman was then switched to the long- acting formulation of octreotide ‘Sandostatin LAR’, which was given as a single IM injection of 20mg. She developed increasingly frequent and severe headaches within 2 weeks of the injection, and she was hospitalised 3 weeks after the injection because of severe hypertension with systolic BP values > 180mm Hg. She was treated with labetolol and then with propranolol. A review of the patient’s records revealed that systolic BP rises had also occurred after each octreotide injection, beginning 15 minutes after the injection, with a peak after 2 hours and a decline to baseline after 3–4 hours. Author comment: ‘The time-dependent association of the transient episodes of hypertension with octreotide therapy and the sustained increase in blood pressure beginning 2-3 weeks after Sandostatin LAR therapy implicate a causative association. . . . Long-acting somatostatin analogues should be used with great caution in patients with diabetic diarrhoea, and fluctuations in blood pressure should be closely monitored.’ Pop-Busui R, et al. Severe hypertension induced by the long-acting somatostatin analogue sandostatin LAR in a patient with diabetic autonomic neuropathy. Journal of Clinical Endocrinology and Metabolism 85: 943-946, Mar 2000 - USA 800816920 1 Reactions 29 Apr 2000 No. 799 0114-9954/10/0799-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
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Transcript of Octreotide
Reactions 799 - 29 Apr 2000
SOctreotide
Hypertension: case reportA 26-year-old woman with type 1 diabetes mellitus and
severe autonomic dysfunction developed severe hypertensionafter receiving the long-acting formulation of octreotide‘Sandostatin LAR’ for diabetic diarrhoea.
The woman had a 16-year history of diabetes mellitus,complicated by severe diabetic autonomic neuropathy,background retinopathy and diabetic nephropathy. Due to herautonomic dysfunction, she had episodes of orthostatichypotension and a 9-year history of severe diarrhoea. Herdiarrhoea had been managed successfully with SC octreotide75µg 3 times daily [duration of therapy not stated], but 1 weekafter the initiation of octreotide therapy she developedheadaches beginning shortly after each octreotide injectionand persisting for 1–2 hours. Systolic BP values during theseheadaches were 130–140mm Hg.
For convenience, the woman was then switched to the long-acting formulation of octreotide ‘Sandostatin LAR’, which wasgiven as a single IM injection of 20mg. She developedincreasingly frequent and severe headaches within 2 weeks ofthe injection, and she was hospitalised 3 weeks after theinjection because of severe hypertension with systolic BPvalues > 180mm Hg. She was treated with labetolol and thenwith propranolol. A review of the patient’s records revealedthat systolic BP rises had also occurred after each octreotideinjection, beginning 15 minutes after the injection, with a peakafter 2 hours and a decline to baseline after 3–4 hours.
Author comment: ‘The time-dependent association of thetransient episodes of hypertension with octreotide therapy andthe sustained increase in blood pressure beginning 2-3 weeksafter Sandostatin LAR therapy implicate a causative association.. . . Long-acting somatostatin analogues should be used withgreat caution in patients with diabetic diarrhoea, andfluctuations in blood pressure should be closely monitored.’Pop-Busui R, et al. Severe hypertension induced by the long-acting somatostatinanalogue sandostatin LAR in a patient with diabetic autonomic neuropathy. Journalof Clinical Endocrinology and Metabolism 85: 943-946, Mar 2000 -USA 800816920
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Reactions 29 Apr 2000 No. 7990114-9954/10/0799-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
