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approvedGI & Metabolic

Vapreotide

Also known as: Sanvar, RC-160, Octastatin, BMY-41606

Vapreotide is a synthetic octapeptide somatostatin analog that binds with high affinity to somatostatin receptors SSTR2 and SSTR5. It was developed for the treatment of acute esophageal variceal bleeding and has been approved in some countries as an alternative to octreotide and terlipressin for this indication. Vapreotide inhibits splanchnic blood flow, reduces portal venous pressure, and suppresses glucagon and growth hormone secretion.

3 cited references·5 researched benefits

Quick Answer

Vapreotide (Sanvar) is a synthetic somatostatin octapeptide analog used to control acute esophageal variceal bleeding in patients with portal hypertension. It works by binding somatostatin receptors SSTR2 and SSTR5, reducing splanchnic blood flow and portal venous pressure. Vapreotide is approved in several countries as a vasoactive agent alongside endoscopic therapy for variceal hemorrhage, with efficacy comparable to octreotide and terlipressin in clinical trials.

Key Facts

Mechanism
Vapreotide binds primarily to somatostatin receptor subtypes SSTR2 and SSTR5 on splanchnic vascular smooth muscle and endocrine cells. Activation of these Gi-coupled receptors inhibits adenylyl cyclase, reducing cAMP levels and causing vasoconstriction of splanchnic arterioles. This decreases portal venous inflow and reduces portal pressure, helping control variceal bleeding. Vapreotide also suppresses secretion of vasoactive peptides including glucagon, VIP, and substance P that contribute to splanchnic vasodilation in portal hypertension. It additionally inhibits growth hormone, insulin, and gastric acid secretion.
Research Status
approved
Half-Life
~30 minutes
Molecular Formula
C₅₇H₇₀N₁₂O₉S₂
Primary Use
GI & Metabolic
Table of Contents

Benefits

  • Controls acute esophageal variceal bleeding by reducing portal venous pressurestrong
  • Reduces splanchnic blood flow in portal hypertensionstrong
  • Suppresses growth hormone and glucagon secretionstrong
  • May reduce rebleeding rates when combined with endoscopic therapymoderate
  • Investigated for symptomatic relief of neuroendocrine tumors and acromegalypreliminary

Dosage Protocols

RouteDosage RangeFrequencyNotes
Intravenous infusion250 mcg bolus, then 250 mcg/hourContinuous infusion for up to 5 daysStandard protocol for acute variceal bleeding: IV bolus followed by continuous infusion alongside emergent endoscopy.
Subcutaneous injection250–500 mcg2–3× dailyUsed in non-acute settings for symptom control in neuroendocrine tumors. Less studied than IV route.

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Abdominal pain and crampingcommon
  • Nausea and vomitingcommon
  • Injection site paincommon
  • Hyperglycemia or hypoglycemia due to altered insulin/glucagon balancerare
  • Bradycardia and cardiac conduction changesserious
  • Gallstone formation with prolonged userare

Frequently Asked Questions

How does vapreotide compare to octreotide for variceal bleeding?
Both are somatostatin analogs used for acute variceal bleeding, and clinical trials show comparable efficacy in controlling hemorrhage and reducing rebleeding rates. Vapreotide has a slightly shorter half-life (~30 minutes vs ~90 minutes for octreotide) and somewhat different receptor affinity profiles. In practice, octreotide is more widely available globally, while vapreotide is approved and commonly used in certain European and Latin American markets. Both are considered acceptable alternatives to terlipressin.
Is vapreotide used for conditions other than variceal bleeding?
Vapreotide has been investigated for acromegaly, neuroendocrine tumors (NETs), and pancreatic fistula management, though it is not widely approved for these indications. Octreotide and lanreotide have become the standard somatostatin analogs for NETs and acromegaly due to their longer half-lives and depot formulations. Vapreotide's clinical niche remains primarily in the acute management of variceal hemorrhage.

References

  1. 1
    Vapreotide, a somatostatin analogue, in the treatment of acute variceal bleeding(1994)PubMed ↗
  2. 2
    Efficacy of vapreotide in prevention of early rebleeding after treatment of acute esophageal variceal bleeding(1999)PubMed ↗
  3. 3
    Somatostatin and its analogs in the management of variceal bleeding(2005)PubMed ↗

Latest Research

Last updated: 2026-02-19