Mycapssa
Mycapssa (octreotide) is an oral somatostatin analog. It's used as maintenance treatment for acromegaly in adults. It's for people who've first done well with injectable somatostatin analogs like octreotide or lanreotide. Mycapssa (octreotide) is a capsule that's taken by mouth twice a day on an empty stomach. Side effects include diarrhea, nausea, and joint pain.
What is Mycapssa (octreotide)?
What is Mycapssa (octreotide) used for?
Long-term maintenance treatment of acromegaly in adults who've responded well to injectable octreotide (Sandostatin, Sandostatin LAR depot) or lanreotide (Somatuline Depot)
How Mycapssa (octreotide) works
Mycapssa (octreotide) is a somatostatin analog. This means it acts just like the somatostatin hormone your body makes. Somatostatin blocks many other hormones from releasing in your body. This includes growth hormone (GH).
Mycapssa (octreotide) helps treat acromegaly by blocking your body from releasing too much GH.
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What are the side effects of Mycapssa (octreotide)?
Common Side Effects
- Headache (33%)
- Nausea (30%)
- Joint pain (26%)
- Weakness (22%)
- Diarrhea (18%)
- Sweating a lot (21%)
- Swelling in your arms, legs, or feet (16%)
Other Side Effects
- Vomiting
- Stomach discomfort
- Indigestion
- Passing gas
- Back pain
- Dizziness
- Tiredness
- Upper respiratory tract infection
- Flu-like symptoms
- High blood sugar
- High blood pressure
Serious Side Effects
- Gallstones and resulting problems: sudden pain in the upper right area of your stomach, swelling in the belly, back pain between your shoulder blades, nausea, vomiting, fever, fast heartbeat, difficulty breathing, yellowing of your skin or eyes
- Dangerously low blood sugar: feeling faint, shaking, sweating, dizziness, fast heartbeat, nervousness, anxious, confused, irritable, feeling very hungry
- Dangerously high blood sugar: feeling thirsty often, needing to urinate often, feeling tired, nausea, vomiting, difficulty breathing, fruity breath, dry mouth
- Heart rate or heart rhythm problems: pounding chest, fluttering in the chest, chest pain, difficulty breathing, feeling faint or lightheaded
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Low blood sugar (hypoglycemia)—tremors or shaking, anxiety, sweating, cold or clammy skin, confusion, dizziness, rapid heartbeat
- Low thyroid levels (hypothyroidism)—unusual weakness or fatigue, increased sensitivity to cold, constipation, hair loss, dry skin, weight gain, feelings of depression
- Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
- Oily or light-colored stools, diarrhea, bloating, weight loss
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Excessive sweating
- Joint pain
- Headache
- Nausea
- Stomach pain
- Swelling of the ankles, hands, or feet
Pros and cons of Mycapssa (octreotide)
Cons
Can't take if you've never used lanreotide or other octreotide medications before
Interacts with common medications, like certain birth control pills, heart rhythm medications, and diabetes medications
Pharmacist tips for Mycapssa (octreotide)
Take Mycapssa (octreotide) twice daily. Take it on an empty stomach, at least 1 hour before or at least 2 hours after a meal.
Swallow Mycapssa (octreotide) whole with a glass of water. Don't crush, chew, or open Mycapssa (octreotide). The capsule shell protects the stomach from irritation. It also protects the medication from stomach acid. This helps the medication get absorbed by the body.
Mycapssa (octreotide) can cause changes in your blood sugar levels. It might be a good idea to keep emergency glucose tablets or hard candy on you in case your blood sugar drops too low. Check your blood sugar if you have symptoms of low blood sugar, like feeling faint, shaky, or sweaty. Treat low blood sugar right away with fasting-acting sugars and call your prescriber.
Tell your care team about all the medications you take and plan to take. This is because Mycapssa (octreotide) interacts with a lot of common medications. Your care team might need to adjust your doses to keep you safe. Some medications that interact with Mycapssa (octreotide) include beta blockers, heartburn medications, and diabetes medications, among others.
Mycapssa (octreotide) might make it easier for you to get pregnant if you're able to become pregnant and sexually active. Ask your prescriber about birth control methods to prevent pregnancy. Note that Mycapssa (octreotide) can make certain birth control pills work less well. So you might need to use other methods like work as well at preventing pregnancy. You might need to use nonhormonal options or extra birth control like condoms.
Mycapssa (octreotide) comes as a wallet of 28 capsules. Store unopened wallets in the refrigerator until the expiration date. Don't let them freeze. After opening a wallet, you can keep it at room temperature for up to 1 month. Safely throw away wallets with leftover capsules if they've been at room temperature for more than 1 month.
Frequently asked questions about Mycapssa (octreotide)
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What are the risks and warnings for Mycapssa (octreotide)?
Mycapssa (octreotide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Gallstones
Mycapssa (octreotide) can raise your risk of gallstones. Sometimes, gallstones can cause problems like swelling in your gallbladder, bile ducts, or pancreas. In very serious cases, some people had to have their gallbladder removed.
Look out for sudden pain in the upper right side of your stomach, back pain between your shoulder blades, or yellowing of your skin or eyes. These can be symptoms of a gallstone. Stop Mycapssa (octreotide) and get medical help right away if you have these symptoms.
Changes in blood sugar levels
Risk factors: Already have problems with blood sugar levels | Diabetes
Mycapssa (octreotide) can change the balance of hormones in your body that control your blood sugar. This can cause your blood sugar to get too high or too low. Your prescriber might ask that you check your blood sugar regularly. In particular, check often when you're starting Mycapssa (octreotide) and when your dose changes.
Tell your prescriber if you have diabetes and take diabetes medications. They might need to be adjusted depending on how Mycapssa (octreotide) affects your blood sugar levels.
Let your prescriber know if you notice any signs of high or low blood sugar while taking Mycapssa (octreotide). Signs of high blood sugar include feeling very thirsty, needing to urinate often, and feeling very tired.
Also watch for signs of low blood sugar, such as feeling dizzy, shaky, sweaty, or faint. It's important to treat low blood sugar right away and get help if it doesn't get better. If not treated, low blood sugar can be life-threatening.
Hypothyroidism (low thyroid hormone levels)
Although it's rare, Mycapssa (octreotide) can lower the amount of thyroid hormone your body makes and cause hypothyroidism. Your prescriber will check your thyroid hormone levels while you take this medication. Let your prescriber know if you feel very tired, gain weight for no clear reason, or feel cold. These could be signs of hypothyroidism.
Abnormal heart rate or heart rhythm
Risk factors: Heartbeat or heart rhythm problems | Taking medications that affect your heartbeat or heart rhythm | Electrolytes (body salts) not in balance
Some people taking Mycapssa (octreotide) might have an abnormal heart rate or heart rhythm. These can include fast or slow heart rate. It can also include abnormal heart rhythms (arrhythmias), which can possibly be dangerous. Call your care team right away if you feel your chest pounding, have chest pain, have trouble breathing, or feel faint. These can be signs of heart problems, and your care team can check it out.
Make sure to tell your prescriber about all the medications you take. Also check with them before you start any new medications. Some medications like beta blockers can affect your heart rate or heart rhythm. So, your prescriber can check if any changes need to be made while you're taking Mycapssa (octreotide).
Low vitamin B12 levels
Some people taking Mycapssa (octreotide) can have lower vitamin B12 levels. Low levels can lead to medical problems like anemia (low red blood cell count) and nerve damage. Your prescriber might check the vitamin B12 levels in your blood during treatment.
Talk to your prescriber if you feel tired, short of breath, or dizzy. Also tell them if you have a "pins-and-needles" feeling or numbness in your hands or feet. These might be signs of vitamin B12 deficiency. If your levels are too low, your prescriber might suggest a supplement to help bring it back up.
Stool changes
Medications like Mycapssa (octreotide) can make your body have trouble absorbing fat from food. This can cause your stool to look fatty, greasy, light colored, and loose. You also might feel bloated or lose weight. Let your prescriber know if you have any of these symptoms while taking Mycapssa (octreotide). They can help you manage this problem.
Risk of unplanned pregnancies
Risk factors: Taking birth control pills containing levonorgestrel
People who can get pregnant and are sexually active might have a higher chance of getting pregnant while taking Mycapssa (octreotide). This medication changes certain hormone levels in a way that might improve fertility.
Mycapssa (octreotide) can also make birth control pills with levonorgestrel work less well. To help prevent pregnancy better, you might need to use nonhormonal options or use extra birth control like condoms. Ask your care team about the best birth control options for you.
Mycapssa (octreotide) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 capsules of 20mg | 2 packages | $6696.35 | $3348.18 |
Typical dosing for Mycapssa (octreotide)
The typical starting dose is 20 mg by mouth twice daily on an empty stomach (at least 1 hour before a meal or at least 2 hours after a meal).
Your prescriber might raise your dose depending on your IGF-1 levels and your symptoms. IGF-1 is responsible for the effects of growth hormone (your symptoms).
The maximum dose is 40 mg twice daily.
Your dose might differ if you have kidney problems.
How much does Mycapssa (octreotide) cost?
Mycapssa (octreotide) contraindications
Allergy to octreotide
What are alternatives to Mycapssa (octreotide)?
Long-term maintenance treatment of acromegaly in adults who've responded well to injectable octreotide (Sandostatin, Sandostatin LAR depot) or lanreotide (Somatuline Depot)
Acromegaly in people who either can't get surgery or radiation, or for whom surgery or radiation didn't work well
Mycapssa (octreotide) images
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References
Best studies we foundAkirov, A., et al. (2021). The biochemical diagnosis of acromegaly. Journal of Clinical Medicine.
American Cancer Society. (n.d.). Chemotherapy.
Chiesi USA, Inc. (2024). Mycapssa- octreotide capsule, delayed release [package insert]. DailyMed.
Daniel, C. P., et al. (2023). Acromegaly: Pathophysiological considerations and treatment options including the evolving role of oral somatostatin analogs. Pathophysiology.
Debnath, D., et al. (2023). Octreotide. StatPearls.
MedlinePlus. (2024). IGF-1 (insulin-like growth factor 1) test.
MedlinePlus. (2024). Low blood sugar.
National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Acromegaly.
Samson, S. L., et al. (2020). Maintenance of acromegaly control in patients switching from injectable somatostatin receptor ligands to oral octreotide. The Journal of Clinical Endocrinology and Metabolism.
U.S. Food and Drug Administration. (2024). Drug disposal: Drug take-back options.
You and Your Hormones. (2021). Growth hormone.
You and Your Hormones. (2021). Somatostatin.
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