Indications & Dose: ACROMEGALY IV/SC Adult Initially 50µg TID, may be increased to 100-200µg TID, once control has been established switch to IM long-acting depot 20mg q4wk, then adjust dose to 10-30mg q4wk after 3 months, max 40mg q4wk | HIV-ASSOCIATED DIARRHEA SC Adult Initially 100µg TID, if it is not controlled after a wk dose increased to 250µg TID if still not effective then therapy should be stopped | PREVENTION OF COMPLICATIONS AFTER PANCREATIC SURGERY SC Adult 100µg TID for 7 consecutive days, beginning at least 1h before laparotomy on the day of operation | SECRETORY NEOPLASMS Emergency therapy IV Adult Bolus Inj: 50µg OD/BID for rapid response as undiluted solution | SC Adult Initially 50µg OD/BID, increased to 600µg/day in 2-4 divided doses based on response, if symptoms not controlled within a wk discontinue. If symptoms controlled MD 20mg (IM, depot preparation) q4wk, then adjust dose to 10-30mg q4wk after 2 or 3 months | VARICEAL HEMORRHAGE IN PATIENTS WITH CIRRHOSIS IV Adult 25µg/h as continuous inf for 2 days, max 50µg/h. In patients at high risk of re-bleeding the treatment may continue up to 5days Child 1 month-18 yr: 1µg/kg/h as continuous inf, if need administrate higher doses initially up to max 50µg/h & the dose should be reduced gradually over 24h if there is no active bleeding

Precautions: CVD, renal/hepatic impairment, elderly

ADR: Serious: Sinus bradycardia, chest pain, conduction abnormalities, HTN, goiter, hypothyroidism, hypoglycemia, hypokalemia, hypoproteinemia, arthralgia, myalgia, renal calculus, Others: Fatigue, headache, constipation, vomiting, biliary duct dilatation, dizziness, pruritus, hyperglycemia, back pain, flatulence, flu symptoms, anxiety, confusion, insomnia, anorexia, cramping, dyspepsia, feces discoloration, glossitis, impotence, URTI, fat malabsorption, stomatitis, xerostomia, gingivitis, UTI

DDI: Serious Bromocriptine bioavailability increased, Insulin leads to hypoglycemia, Ciclosporin levels reduced & leads to inadequate immunosuppression, Antidiabetics reduces insulin secretion & impair glucose tolerance (in non-diabetics)

Diet: With food

Monitor: Growth hormone, somatomedin C , plasma serotonin & plasma substance P, vasoactive intestinal peptide, vit B12 level, blood glucose, glycemic control & antidiabetic regimen, TFT, cardiac function