In the majority of acromegalics, if octreotide is administered subcutaneously in doses of 300-600┬╡g per day (100-200┬╡g eight hourly), GH levels are suppressed such that fifty-five per cent of patients have average levels below 10mu/l, compared to fourteen per cent with bromocriptine.
In the same patients octreotide proves more effective than bromocriptine (Fig. 3.26) and, unlike bromocriptine, causes no suppression of prolactin secretion except in some rare, mixed secretory mammosomatotroph tumours. Usually, carbohydrate tolerance does not worsen with octreotide administration, despite transient insulin suppression. Symptomatic relief is good and headaches may be dramatically reduced.
