醋酸奧曲肽
Octreotide Acetate
Octreotide acetate
別名: Sandostatin LAR Depot · Longastatina · Samilstin · Sandostatina · Sandostatine · SMS-201-995
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Medical treatment of insulinoma (beta cell tumor) particularly in patients refractory to or unable to tolerate other medical or surgical therapy | 10-40 micrograms (total dose per dog) | SC | 2-3 times a day | — | 🌎 NA |
| Medical treatment of insulinoma | 2-4 micrograms/kg | SC | q8-12h | — | 🌎 NA |
| Adjunctive treatment of gastrinoma | 2-20 micrograms/kg | SC | three times daily | — | 🌎 NA |
| Adjunctive treatment of chylothorax | 10-20 micrograms/kg | SC | three times a day | 2-3 weeks | 🌎 NA |
- Medical treatment of insulinoma (beta cell tumor) particularly in patients refractory to or unable to tolerate other medical or surgical therapy: Used in combination with dietary, glucocorticoid, and diazoxide treatment.
- Medical treatment of insulinoma: Further studies needed to determine octreotide's efficacy and safety.
- Adjunctive treatment of gastrinoma: With omeprazole.
- Adjunctive treatment of chylothorax: Prolonged treatment should be discouraged because people treated for longer than 4 weeks are at risk for gallstones.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Adjunctive treatment of chylothorax | 10-20 micrograms/kg | SC | three times a day | 2-3 weeks | 🌎 NA |
- Adjunctive treatment of chylothorax: Prolonged treatment should be discouraged because people treated for longer than 4 weeks are at risk for gallstones.
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Medical treatment of insulinoma (particularly in patients refractory to or unable to tolerate other medical or surgical therapy) | 1-2 micrograms/kg | SC | 2-3 times a day | — | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
醋酸奧曲肽 (Octreotide acetate) 是一種人工合成的長效八肽化合物，為天然體抑素 (somatostatin) 的類似物。在獸醫學中，主要作為神經內分泌腫瘤（如犬和雪貂的胰島素瘤及胃泌素瘤）的輔助治療。
主要臨床重點：
- 胰島素瘤管理：透過抑制腫瘤性β細胞釋放胰島素來幫助穩定血糖，但由於受體表現的差異，療效因個體而異。
- 乳糜胸：越來越多被標示外使用於控制乳糜性胸水，其機制為減少內臟血流及淋巴液的產生。
- 限制：需要每天多次皮下注射，且對於大型犬而言費用可能相當昂貴。對貓的肢端肥大症無效。
作用機制
Octreotide mimics natural somatostatin by binding to somatostatin receptors (SSTRs) on target cells.
Mechanism pathway: Octreotide → binds to SSTRs (G-protein coupled receptors) → inhibits adenylyl cyclase → decreases intracellular cAMP → reduces calcium influx → inhibits exocytosis of secretory vesicles.
This leads to the potent suppression of multiple endocrine and exocrine secretions, including:
- Insulin and glucagon from the pancreas.
- Gastrin, secretin, and motilin from the gastrointestinal tract.
- Growth hormone (GH) from the anterior pituitary.
Note: Humans possess 5 SSTR subtypes, whereas dogs primarily express one, which may explain the variable clinical response seen in canine insulinoma patients.
安全性與警告
禁忌症
- Known hypersensitivity to octreotide
不良反應
- Gastrointestinal upset
- Decreased dietary fat absorption
- Biliary sludging or gallstones (with prolonged use)
- Injection site pain
注意事項
Caution: Use with care in patients with biliary tract disorders or severe renal dysfunction (dosage adjustment may be necessary). Prolonged use (>4 weeks) may increase the risk of gallstone formation. Safety in pregnant or nursing animals is not fully established (FDA Category B in humans).
藥物相互作用
May cause additive bradycardic effects
May increase oral bioavailability
May cause additive bradycardic effects
May reduce cyclosporine levels
May enhance fluid/electrolyte imbalances
May reduce fat absorption
Octreotide can inhibit insulin
May reduce the quinidine clearance
監測
- Blood glucose (for insulinoma treatment)
- Clinical efficacy
藥物動力學
吸收
Absorbed rapidly from the injection site after SC administration.
分佈
Distributed rapidly.
代謝
Degraded primarily by peptidases.
排除
About 32% of a dose is excreted unchanged in the urine.
過量
Serious adverse effects are unlikely with acute overdose. In humans, subjects have received up to 120 mg IV over 8 hours with no untoward effects. Monitor for profound hypoglycemia or gastrointestinal distress and provide supportive care if needed.
可用產品
劑型
- Injection solution
- Powder for injectable suspension (depot)
人用標示
- Octreotide Acetate for Injection: 0.05 mg/mL (50 micrograms/mL), 0.1 mg/mL (100 micrograms/mL), 0.2 mg/mL (200 micrograms/mL), 0.5 mg/mL (500 micrograms/mL) & 1 mg/mL (1,000 micrograms/mL) in 1 mg amps, single-dose vials and 5 mL multi-dose vials
- Octreotide Acetate Powder for Injectable Suspension: 10 mg/5 mL, 20 mg/5 mL & 30 mg/5mL in single-use kits (Sandostatin LAR Depot)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
When stored at room temperature and protected from light, octreotide acetate injection remains stable for 14 days. For long-term storage, keep refrigerated. If injecting solution that has been in the refrigerator, allow it to come to room temperature in the syringe before injecting. Do not use artificial warming techniques. It is recommended to use multidose vials within 14 days of initial use.
飼主須知
- 實驗性療法：此藥物在獸醫病患中的使用經驗有限，通常被視為標示外或實驗性治療。
- 給藥方式：必須嚴格按照獸醫的指示給藥，通常為每天2至3次皮下注射。
- 費用：此藥物的費用可能非常高昂，特別是對於體型較大的狗。
- 監測：如果是用於治療胰島素瘤，請密切觀察寵物是否有低血糖的跡象（如虛弱、嗜睡、步態不穩或癲癇發作），若出現這些症狀請立即聯繫獸醫。
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