Somaset Dosage/Direction for Use

Adults: The recommended dose is 3.5 mcg/kg body weight/hr, or usually 6 mg/24 hrs for a 75-kg patient, given as a continuous infusion of 250 mcg/hr. The infusion rate should then be adjusted for 12 or 24 hrs (for 3 or 6 mg respectively).
Treatment of Gastrointestinal Hemorrhage: Somatostatin infusion should be initiated before endoscopy, as soon as possible after the first signs of bleeding, and continued for 5 days, the minimum duration being 48 hrs. In addition to the continuous infusion, a bolus injection of 3.5 mcg/kg body weight (1 vial of Somatostatin 0.25 mg for a 75-kg patient) should be given immediately after the start of the continuous infusion and another bolus about 1 min before endoscopy. The bolus must be given slowly (at least 1 min). After endoscopic treatment, similar boluses should also be given when the patient shows clinical signs of bleeding.
Treatment of Fistulae or Excessive Secretion from Endocrine Tumors: A bolus injection is not necessary. Healing of fistulae may be expected in most patients within 7-14 days, although longer (or shorter) periods are possible. After healing, only half the dose should be infused for the next 48 hrs, in order to avoid a possible rebound effect.
Elderly: Adjustment of the dose is recommended in elderly patients with severe renal impairment (see Renal Impairment as follows).
Renal Impairment: In patients with severe renal failure (CrCl ≤30 mL/min), the dose should be reduced to 1.75 mcg/kg body weight/hr for continuous infusion and 1.75 mcg/kg body weight for bolus dose.
Hepatic Impairment: No dose adjustment is needed in patients with solely hepatic impairment. The patient should be closely monitored after treatment discontinuation.
Administration: Due to its short plasma t_1/2, 1-2 min, Somatostatin should be administered as a continuous I.V. infusion. It should be reconstituted immediately before use by adding the 1 mL ampoule of sodium chloride solution (0.9%) for parenteral use.