Octreotide acetate injection (Sandostatin LAR Depot, Sandostatin)

Covered: octreotide (Sandostatin LAR/injection) is approved only for the FDA‑listed indications—acromegaly, metastatic carcinoid tumor–related severe diarrhea and flushing, and VIPoma‑related profuse watery diarrhea—and off‑label uses are not supported. Key requirements: approval (up to 12 months) requires indication‑specific documentation (for acromegaly: clinical signs, elevated pretreatment IGF‑1, and not a surgical candidate or prior noncurative surgery; reauthorization requires decreased/normalized IGF‑1 on therapy) and adherence to recommended safety monitoring (gallbladder, glucose, thyroid, B12, zinc if TPN, CYP3A4 interactions, cardiac risk).

"Treatment of acromegaly"

Sign up to see full coverage criteria, indications, and limitations.