Starting Sandostatin LAR Depot (octreotide acetate)Your first 90 days with acromegaly: the steps, the dates and who to call

How you take it

One shot into the buttock muscle every 4 weeks, given by a trained nurse or doctor. It starts at 20mg, and after 3 months your blood tests decide whether the dose stays the same, goes up or goes down.

Before your first dose

• First you take short-acting Sandostatin, a small shot under the skin 3 times a day, for at least 2 weeks. This shows whether the medicine works for you and whether you can handle it.
• Someone from your doctor's office shows you, or a helper, how to give the small shots cleanly and safely.
• Blood tests of growth hormone (GH) and IGF-1 show your doctor whether the medicine is working. If it is, you can move to the monthly shot.
• A thyroid blood test near the start, because octreotide can lower thyroid hormone.
• Your insurance approves the monthly shot before the first one is given. Novartis Patient Support, the drugmaker's help line at 1-800-282-7630, can help with coverage and costs.

The first 90 days

1. About 4 weeks beforeInsurance approval for the monthly shot
2. At least 2 weeks beforeStart the small shots under the skin, 3 times a day
3. StartStart the small shots under the skin, 3 times a day
4. Before the switchBlood tests show whether you can switch to the monthly shot
5. Day 1First Sandostatin LAR Depot shot, 20mg
6. StartBlood sugar check
7. First monthStomach side effects, mostly early
8. Every 4 weeks, then every 28 daysShot 2, then every 4 weeks
9. Week 9Shot 3, the last of the first 3 months
10. About month 3Blood tests of GH and IGF-1, about 3 months in
11. Shot 4Fourth shot, at the dose your blood tests point to