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Pharmacokinetics of octreotide in patients with cirrhosis and portal hypertension; relationship between the plasma levels of the analogue and the magnitude and duration of the reduction in corrected wedged hepatic venous pressure.
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MedLine Citation:
PMID:  9830576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In healthy subjects octreotide is largely metabolised by the liver suggesting that the plasma half-life of the somatostatin analogue may be prolonged in patients with hepatic dysfunction. The aim of this study was therefore (a) to determine the pharmacokinetics of octreotide following its subcutaneous injection in 6 patients with cirrhosis and portal hypertension and (b) compare the magnitude and duration of the effects of intravenous administration of 250 micrograms somatostatin and 50 micrograms octreotide on corrected wedged hepatic venous pressure (WHVP) and to relate the findings to the plasma levels of the analogue 1 h after administration in 13 patients with cirrhosis and portal hypertension. Following subcutaneous administration of 50 micrograms octreotide the circulating half life (range 2.4 to 4.79 h) was prolonged whereas the clearance (range 2.101 to 4.775 L/h) was decreased compared to healthy controls. Intravenous bolus administration of 250 micrograms somatostatin or 50 micrograms octreotide resulted in a reduction in WHVP of approximately the same magnitude and duration despite appreciable quantities of the analogue in the blood 1 h after administration (1944 +/- 226 pg/ml). These results indicate that the circulating half-life of octreotide is prolonged in cirrhotics suggesting that the dosage regimens should be modified in such patients to avoid accumulation of the analogue in the blood which may result in undesirable side-effects or toxicity. Furthermore, since the magnitude and duration of the reduction in WHVP elicited by IV octreotide is similar to that observed with somatostatin, the analogue, like the native hormone, must be administered by continuous IV infusion to produce a sustained response and hence a therapeutic effect in the management of acute variceal bleeding.
Authors:
S A Jenkins; D M Nott; J N Baxter
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  HPB surgery : a world journal of hepatic, pancreatic and biliary surgery     Volume:  11     ISSN:  0894-8569     ISO Abbreviation:  HPB Surg     Publication Date:  1998  
Date Detail:
Created Date:  1999-01-28     Completed Date:  1999-01-28     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9002972     Medline TA:  HPB Surg     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  13-21     Citation Subset:  IM    
Affiliation:
University Department of Surgery, Royal Liverpool University Hospital.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects*
Female
Half-Life
Hepatic Veins / drug effects*,  physiopathology
Hormones / administration & dosage,  blood,  pharmacokinetics*,  pharmacology
Humans
Hypertension, Portal / blood,  drug therapy*,  physiopathology
Injections, Intravenous
Injections, Subcutaneous
Liver Cirrhosis / blood,  drug therapy*,  physiopathology
Male
Octreotide / administration & dosage,  blood,  pharmacokinetics*,  pharmacology
Somatostatin / administration & dosage,  pharmacology
Statistics, Nonparametric
Time Factors
Chemical
Reg. No./Substance:
0/Hormones; 51110-01-1/Somatostatin; 83150-76-9/Octreotide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Full Text
Journal Information
Journal ID (nlm-ta): HPB Surg
ISSN: 0894-8569
ISSN: 1607-8462
Publisher: Hindawi Publishing Corporation
Article Information
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Copyright ? 1998 Hindawi Publishing Corporation.
open-access: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Accepted Day: 3 Month: 6 Year: 1997
Print publication date: Month: 8 Year: 1998
Volume: 11 Issue: 1
First Page: 13 Last Page: 21
ID: 2423925
PubMed Id: 9830576
Publisher Item Identifier: S0894856998174362
DOI: 10.1155/1998/17436

Pharmacokinetics of Octreotide in Patients With Cirrhosis and Portal Hypertension; Relationship Between the Plasma Levels of the Analogue and the Magnitude and Duration of the Reduction in Corrected Wedged Hepatic Venous Pressure
S. A. Jenkins12
D. M. Nott13
J. N. Baxter12
1University Department of SurgeryRoyal Liverpool University HospitalLiverpoolL7 8XPUnited Kingdom
2Department of SurgeryPostgraduate Medical SchoolMorriston HospitalSwanseaMorristonSA6 6NLUSA
3Academic Department of SurgeryChelsea and Westminster HospitalLondonSW 10 9NHUnited Kingdom


Article Categories:
  • Research Article


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