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vapreotide

H01CB04

Forms & Strengths

Injectable solution: 50 mcg/mL, 100 mcg/mL, 250 mcg/mL

Adult Dosing

Esophageal variceal bleeding: 50 mcg IV bolus followed by 50 mcg/hour continuous IV infusion for up to 5 days
Carcinoid syndrome and VIPomas: 50 to 100 mcg subcutaneously every 8 to 12 hours, titrated based on clinical response

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established

Indications

Management of acute bleeding from esophageal varices in cirrhosis
Symptomatic treatment of neuroendocrine tumors such as carcinoid tumors and vasoactive intestinal peptide-secreting tumors (VIPomas)

Mechanism of Action

Synthetic cyclic octapeptide analogue of natural somatostatin
Binds to somatostatin receptors (SSTR subtypes 2 and 5) with high affinity
Inhibits the release of growth hormone, serotonin, gastrin, vasoactive intestinal peptide, insulin, and glucagon
Reduces splanchnic blood flow and portal venous pressure, decreasing variceal hemorrhage

Contraindications

Known hypersensitivity to vapreotide or any component of the formulation
Pregnancy and lactation due to potential risks of hormonal disruption

Adverse Reactions

Cardiovascular: Bradycardia, flushing, transient hypotension or hypertension
Gastrointestinal: Abdominal pain, nausea, diarrhea, steatorrhea, flatulence
Metabolic: Hyperglycemia or hypoglycemia due to altered insulin and glucagon regulation
Local: Pain, erythema, or burning sensation at the subcutaneous injection site

Drug Interactions

Insulin and oral hypoglycemic agents: May require dose adjustment due to altered glucose homeostasis
Beta-blockers and calcium channel blockers: Potential for additive bradycardia or blood pressure reduction
Cyclosporine: Vapreotide may decrease serum concentration and absorption of cyclosporine
Drugs metabolized by cytochrome P450 enzymes: Potential indirect effects through altered endocrine regulation

Curated Content: Needs Vetting Before Put to Clinical Use