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Octreotide

Aliases: Sandostatin · Sandostatin LAR

Last verified: 2026-09-23

Approved drugStrong evidencePeptidesMedium interest

The short version

A somatostatin-analogue octapeptide — approved for acromegaly, neuroendocrine tumors and variceal bleeding; "brakes" GH, insulin, glucagon, GI hormones.

Identity & type

Molecular type
analog
Origin
A somatostatin-analogue octapeptide — approved for acromegaly, neuroendocrine tumors and variceal bleeding; "brakes" GH, insulin, glucagon, GI hormones.

Mechanism of action

SSTR2/SSTR5 agonism → inhibition of endocrine secretion and splanchnic flow.

Dosing & routes

Official / clinical context

Approved drug — indications, dosing and warnings are defined by the official label. SC 50–200 mcg 2–3×/day; LAR depot 10–30 mg monthly.

Regulator-approved labeling and published study designs — never a recommendation.

Community-reported practice

SC 50–200 mcg 2–3×/day; LAR depot 10–30 mg monthly. Sandostatin: in acromegaly and NET tumors — GH/IGF-1 reduction, diarrhea/flush-syndrome control; patients notice fast symptom control but also gallstones long-term.

Unverified self-reports. Not medical advice. Not endorsement.

Expected effects (community)

Sandostatin: in acromegaly and NET tumors — GH/IGF-1 reduction, diarrhea/flush-syndrome control; patients notice fast symptom control but also gallstones long-term.

Protocol — official vs community

Official / label

Sandostatin (acromegaly, neuroendocrine tumors, carcinoid/VIPoma, refractory diarrhea): SC 50–200 mcg 2–3×/day. Sandostatin LAR depot: 10–30 mg IM every 4 weeks.

  1. 01Acromegaly: titrate by IGF-1 and GH response between SC doses or LAR strengths (10 → 20 → 30 mg monthly)
  2. 02LAR conversion: overlap SC with the first LAR dose for ~2 weeks while depot levels build

Duration: Chronic — disease control requires continuous treatment; symptom control is lost within days to weeks of stopping.

Gallstones, steatorrhea and glucose dysregulation are the long-term costs of broad somatostatin agonism. Rapid symptom relief in carcinoid flushing and VIPoma diarrhea is its signature effect.

Community (anecdotal)

Gray-market vials are typically dosed at 100–200 mcg SC 2–3×/day, mirroring the label. Community discussions revolve around insulin/GH-axis experiments ('glucose regulation') and reactive hypoglycemia rather than its approved uses.

Cycle:
Ad-hoc days to weeks; no consistent pattern.
Break:
None defined by community practice.

The community footprint is small and speculative. Octreotide is cheap and generic, which is the only reason it appears in this space at all — its pharmacology punishes casual use (biliary stasis, hypoglycemia-adjacent glucose swings).

Human evidence

Standard in NET; Ga-68 DOTATATE imaging + PRRT therapy (Lutathera) built on this ligand.

Preclinical evidence

The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.

Known risks

  • Gallstones, steatorrhea, glucose swings.characterized

Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.

Unknowns & evidence gaps

  • Real-world data outside controlled trials

Frequently asked questions

References