Somatostatin

Well-established endocrine biology. Native somatostatin is rarely used due to its very short half-life; synthetic analogs are standard of care for acromegaly and neuroendocrine tumors.

A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.

Extensive clinical use via analogs (octreotide, lanreotide, pasireotide). Native somatostatin used in acute variceal bleeding. One of the most well-characterized regulatory peptides.

• Standard-of-care analogs for acromegaly and carcinoid tumors
• Native peptide used in acute variceal bleeding
• Well-characterized endocrine inhibitory functions

Native: 250 mcg/hr IV infusion for variceal bleeding. Octreotide: 100–500 mcg SC 2–3 times daily.

• Gallstones (with chronic analog use)
• Hyperglycemia or hypoglycemia
• GI disturbances (diarrhea, steatorrhea)
• Injection-site reactions

Native form requires continuous IV infusion. Analogs can cause gallstones, hyperglycemia, and GI effects.

Clinical utility is through analogs, not native somatostatin for most indications.