What medication is used to manage carcinoid syndrome?

Octreotide is a synthetic analog of somatostatin and is the primary medication used to manage carcinoid syndrome. Carcinoid syndrome occurs due to the secretion of serotonin and other vasoactive substances from neuroendocrine tumors, particularly those originating in the gastrointestinal tract. The symptoms can include flushing, diarrhea, wheezing, and heart valve abnormalities due to the high levels of serotonin.

Octreotide works by inhibiting the release of serotonin and other related substances, thereby alleviating the symptoms associated with carcinoid syndrome. It reduces gastrointestinal motility and inhibits hormone secretion, which provides significant relief from symptoms like diarrhea and flushing.

While somatostatin itself can also be effective, it is less commonly used in clinical practice compared to octreotide due to pharmacokinetic differences; octreotide has a longer half-life and is more convenient for administration. Other options such as cimetidine, which is an H2 receptor antagonist primarily used to decrease stomach acid, and metoclopramide, which is a prokinetic agent for gastrointestinal motility, are not effective in treating the hormonal dysregulation or symptomatology of carcinoid syndrome. Thus, octreotide remains the mainstay treatment for managing this condition