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The following information outlines essential safety warnings related to the use of octreotide. It is crucial to carefully consider these details and consult with your healthcare provider if you have any concerns or questions.

• Blood Sugar Changes: Octreotide may disrupt the hormonal balance that regulates blood sugar, potentially leading to hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Regular monitoring of blood sugar levels is advised, especially when beginning treatment or adjusting dosages. If you are on diabetes medication, dosage adjustments may be necessary. Be aware of symptoms such as excessive thirst, frequent urination, fatigue (high blood sugar), faintness, shaking, sweating, and dizziness (low blood sugar). Immediate treatment and medical attention for low blood sugar symptoms are crucial to prevent life-threatening situations. Consult your healthcare provider with any concerns about blood sugar management.

• Heart Issues: Octreotide can cause serious heartbeat or heart rhythm disturbances, which may be life-threatening. This risk is heightened in individuals with pre-existing heart conditions or those taking medications that affect heart rhythm, such as beta-blockers. Inform your healthcare provider of all medications you are taking and seek approval before starting any new ones. If you experience symptoms such as a pounding chest, difficulty breathing, lightheadedness, or chest pain, seek emergency medical help immediately by calling 911.

• Gallstones Risk: There is an increased risk of developing gallstones and associated complications, including inflammation of the gallbladder, bile ducts, or pancreas. Severe cases may require surgical removal of the gallbladder. Symptoms such as sudden upper right abdominal pain, back pain, nausea, or vomiting should prompt immediate discontinuation of the medication and seeking of medical assistance.

• Thyroid Function: Rarely, octreotide can decrease thyroid hormone production, leading to hypothyroidism. Regular thyroid function tests may be ordered by your healthcare provider. Symptoms such as fatigue, weight gain, and feeling cold should be reported promptly to your healthcare provider.

• Nutrient Absorption: Octreotide may impair the absorption of nutrients like vitamin B12, fats, and zinc, possibly resulting in symptoms such as fatty stools, loose stools, weight loss, and bloating. Discuss any such symptoms with your healthcare provider.

• Unintended Pregnancies: Octreotide may alter hormone levels, increasing the risk of unintended pregnancies. If you are capable of becoming pregnant and are sexually active, consult your healthcare provider about suitable contraceptive options.

It is important to adhere to these precautions to ensure safe and effective use of octreotide. Always follow your prescriber's guidance and reach out for assistance if you experience any of the symptoms or have questions regarding your treatment.

Common side effects:

• nausea
• vomiting
• diarrhea
• constipation
• stomach upset
• gas
• bloating
• dizziness
• headache
• pain or irritation at the injection site

Less common but important to monitor:

• fever
• severe abdominal pain
• yellowing of the skin and eyes
• unexplained weight gain
• cold intolerance
• severe constipation
• irregular heartbeat
• trouble breathing
• increased thirst
• frequent urination
• shakiness
• sweating
• fast heartbeat

Serious side effects:

• rash
• itching
• swelling
• severe dizziness
• trouble breathing

Octreotide, a medication used to manage certain hormonal disorders and symptoms associated with specific tumors, can interact with various other drugs, potentially affecting their efficacy or increasing the risk of side effects. It's important to be aware of these interactions to ensure safe and effective treatment.

Cyclosporine: When taken together, octreotide may reduce the absorption of cyclosporine, a drug commonly used to prevent organ transplant rejection. This reduction can lead to decreased cyclosporine levels in the blood, potentially resulting in transplant rejection.

Insulin and Oral Diabetes Medications: Octreotide can influence blood sugar levels by inhibiting the secretion of insulin and glucagon. This effect may necessitate adjustments in the dosages of insulin or oral diabetes medications to maintain proper blood glucose control.

Bromocriptine: Concurrent use of octreotide and bromocriptine, a medication used for conditions like Parkinson's disease and certain hormonal disorders, can increase the availability of bromocriptine in the body. This interaction may enhance the effects of bromocriptine, requiring careful monitoring.

Beta-Blockers and Other Heart Medications: Octreotide may slow heart rate. When combined with beta-blockers or other medications that also reduce heart rate, there can be an additive effect, potentially leading to bradycardia (a slower than normal heart rate). Dose adjustments of these heart medications may be necessary.

Drugs Metabolized by Cytochrome P450 Enzymes: Octreotide might decrease the clearance of drugs metabolized by certain liver enzymes, particularly those processed by CYP3A4. This interaction can lead to higher levels of these drugs in the bloodstream, increasing the risk of side effects. Caution is advised when using octreotide with medications that have a narrow therapeutic index and are metabolized by CYP3A4, such as quinidine.

Lutetium Lu 177 Dotatate: Octreotide binds to somatostatin receptors, which can interfere with the effectiveness of lutetium Lu 177 dotatate, a radiopharmaceutical used in certain cancer treatments. To minimize this interaction, it's recommended to discontinue octreotide at least 24 hours before administering lutetium Lu 177 dotatate.

Warfarin: There have been reports of increased blood thinning effects when octreotide is used with warfarin, an anticoagulant medication. This interaction can lead to elevated INR levels, increasing the risk of bleeding. Patients on both medications should have their blood clotting parameters closely monitored.

Given these potential interactions, it's crucial to inform your healthcare provider about all medications, supplements, and over-the-counter drugs you are currently taking before starting octreotide therapy. Regular monitoring and possible dose adjustments may be necessary to ensure safe and effective treatment.