Lanreotide (Subcutaneous)

Lanreotide is sold under the brand name Somatuline Depot and works by reducing the levels of growth hormone that is produced by the body.

Overview

Lanreotide is a man-made hormone used for long-term treatment of a growth hormone disorder known as acromegaly in patients who cannot be treated via radiation or surgical procedures. Acromegaly is a condition in which the pituitary gland secrets excessive amounts of growth hormones leading to overgrowth of certain body parts, such as the hands and face.

Sold under the brand name Somatuline depot, this medicine works by lowering the levels of growth hormone (GH) and insulin-growth factor 1 hormone in the body. Lanreotide is also administered to treat neuroendocrine tumors in the pancreas (GEP-NET) or gastrointestinal tract that has spread and cannot be removed using a surgical procedure.

Lanreotide's mechanism of action is similar to that of endogenous somatostatin. The medication reduces GH and insulin growth factor-1 (IGF-1) concentrations allowing these hormones to normalize in patients with acromegaly. Additionally, lanreotide inhibits various exocrine, neuroendocrine, endocrine, and paracrine functions including gastric inhibitory peptide, basal secretion of motilin, and pancreatic polypeptide. It also inhibits the postprandial secretion of gastrin, pancreatic polypeptide, and cholecystokinin. Lanreotide also modifies hemostasis of glucose while reducing or delaying the secretion of post-prandial insulin secretion. This results in a transient, mild glucose intolerance. Long-term lanreotide use causes a decrease in concentration of prolactin in patients with acromegaly.

Conditions Treated

  • Acromegaly
  • Carcinoid syndrome
  • Certain gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

Type Of Medicine

  • Antigrowth Hormones

Lanreotide side effects

Along with the desired effects, a drug may cause some unwanted effects. These side effects vary from patient to patient as well as in severity. Check with your healthcare provider or the emergency room immediately if you experience any of the following side effects while on lanreotide treatment:

  • Blurred vision
  • Abdominal or stomach fullness
  • Chest pain and discomfort
  • Headache
  • Dizziness, lightheadedness, and fainting
  • Nervousness
  • Pounding in the ears
  • Pale skin
  • Recurrent fever
  • Uneven heartbeat
  • Shortness of breath
  • Unusual breathing with exertion
  • Unusual tiredness and general body weakness
  • Unusual bleeding or bruising
  • Yellowing of skin and eyes

Some lanreotide side effects do not need medical attention as they often go away as the body adjusts to the medication. In addition, your healthcare provider may be able to advise you on how to reduce the severity of these side effects. That said, check with your healthcare provider if the following side effects persist or become bothersome.

  • Diarrhea
  • Bloated or full feeling
  • Difficulty having a bowel movement
  • Excess gas in the stomach
  • Moving with difficulty
  • Inflammation, lumps, itching, or pain at the injection spot
  • Nausea and vomiting
  • Muscle pain or stiffness
  • Weight loss
  • Pain in the joints

Call your healthcare provider for advice on how to manage these side effects. You may also report the side effects to the FDA at 1-800-FDA-1088.

Lanreotide dosage

Lanreotide is administered via deep skin injection (deep subcutaneous route). Due to the need for close monitoring during treatment self-injection is not advisable. The medication is administered once every four weeks, and your doctor or nurse will administer it by injecting into the buttocks. Most often, this medication is prescribed for three months upon which adjustments may be recommended if tests show reduction in growth hormones and insulin growth factor hormone. Your doctor may recommend a six to eight-week dose adjustment if adequate control of hormones is achieved.

Your doctor will recommend regular lab tests to check your treatment progress. It is very important that you take these tests.

Since lanreotide will be administered by a health professional, overdosing is unlikely. Call your doctor right away if you miss your injection appointment.

Dosage When Treating Acromegaly

Treatment should start with 90 mg of lanreotide administered via deep subcutaneous route, at 4-week intervals for up to three months. Based on the patient's response to treatment, the dosage may be adjusted after 3 months of treatment.

  • Treating gastrointeropancreatic neuroendocrine tumor (GEP-NET)
  • The recommended dosage and schedule is 120 mg of lanreotide administered via deep subcutaneous route every 28 days.
  • Treating carcinoid syndrome
  • The recommended dosage and schedule is 120 mg of lanreotide administered via deep subcutaneous route every 28 days.

Lanreotide interactions

Although certain medications should never be used together, in other cases two different medicines may be combined even if this might cause an interaction. Under such circumstances, your healthcare provider will recommend a change of dosage for one or both medications or recommend appropriate precautions. Inform your healthcare provider about the medications you are currently on before starting lanreotide therapy. These include over-the-counter medications, supplements, multivitamins as well as herbal medicines.

Additionally, do not take the following medications while on lanreotide treatment without the approval of your healthcare provider:

  • Albiglutide
  • Acarbose
  • Chlorpropamide
  • Dulaglutide
  • Exenatide
  • Alogliptin
  • Canagliflozin
  • Cyclosporine
  • Dapagliflozin
  • Empagliflozin
  • Glipizade
  • Glimepiride
  • Glyburide
  • Insulin Bovine
  • Insulin Detemir
  • Insulin Lispro, Recombinant
  • Liraglutide
  • Nateglinide
  • Linagliptin
  • Saxagliptin
  • Pramlintide
  • Vildagliptin
  • Terfenadine
  • Repaglinide
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Degludec
  • Insulin Glargine, Recombinant
  • Insulin Glulisine
  • Lixisenatide
  • Metformin
  • Miglitol
  • Pioglitazone
  • Quinidine
  • Rosiglitazone
  • Sitagliptin
  • Tolazamide
  • Tolbutamide

Interactions With Food/Tobacco/Alcohol

Certain foods should be avoided while on some medications since this might cause interaction. Using alcohol and tobacco products with certain medications may also trigger an interaction. Discuss with your healthcare provider the use of lanreotide with food, alcohol and tobacco products. Specifically, avoid using alcohol while on this medication as it might affect the efficiency of the medication.

Other Medical Problems

Certain pre-existing medical conditions may affect the use, and efficiency, of lanreotide. Be sure to inform your healthcare provider if you have any of the following medical conditions, especially:

  • A history of bradycardia (slow heartbeat)
  • A history of gallbladder disease
  • Diabetes
  • A history of heart disease
  • Thyroid problems
  • Hypertension
  • Liver disease
  • Kidney disease

Lanreotide warnings

It is important that your healthcare provider schedules regular tests to make sure that lanreotide is working properly. During these tests, blood and urine tests should be performed to check for any unwanted effects.

Long term use of lanreotide may increase your risk of developing gallstones. Consult your healthcare provider right away if your experience persistent abdominal pain that is accompanied with nausea and vomiting

Lanreotide may cause a rise and fall in your blood sugar levels. Check with your healthcare provider if you notice a considerable change in your blood or urine sugar test.

Lanreotide may make you feel dizzy. Do not drive, operate machinery or perform tasks that require you to be alert until you know how this medication affects you.

Do not take any other medication before consulting your healthcare provider. These include prescription as well as non-prescription medication, supplements, vitamins, as well as herbal medications.

Contact your doctor if you are allergic to lanreotide or any of its ingredients. Also, inform your doctor of any history of allergic reactions, including medical, food, paint, and animal allergies.

The efficacy of lanreotide in children is yet to be established. As such, this medication should not be administered to children and patients under 18 years of age.

Due to risk of liver and kidney problems, the use of lanreotide in elderly patients should be accompanied with very close monitoring.

If you are pregnant, inform your healthcare provider before starting lanreotide therapy. The FDA classifies lanreotide as a category C drug, meaning it can harm the unborn baby if administered to expectant patients.

Due to the potential for serious adverse reactions in breastfeeding babies from lanreotide, including bradycardia and the effects of glucose metabolism, nursing mothers are advised to discontinue breastfeeding during lanreotide treatment and for up to six months from the final injection.

Lanreotide should be used with caution in patients with a history of cardiac disease or pre-existing bradycardia.

Prolonged use of lanreotide may affect the patient's reproductive system with the potential of causing infertility.

Storage

Lanreotide should be refrigerated (35 to 45 degrees F). Keep the medication away from pets and children. This drug is very harmful when ingested, especially to humans. Thus, it should be stored in the original container to avoid accidental ingestion.

Do not flush the medication down the sink or toilet unless advised to do so. Consult your pharmacist on how to properly dispose of expired medications or medications that you no longer use.

Summary

Lanreotide is a synthetic protein used to treat acromegaly (a growth hormone disorder). It is administered to patients who cannot be treated using radiation or surgical procedures. It is similar to somatostatin that is secreted by the hypothalamus. It works by 'Å“switching off' the secretion of growth hormone in the pituitary gland. It also decreases splanchnic blood flow and inhibits the release of gastrin, serotonin, secretin, vasoactive intestinal peptide, pancreatic polypeptide, and motilin.

Like other medications, lanreotide comes with its share of side effects. It is important that you discuss the merits and demerits associated with this medication before beginning the therapy. Additionally, be sure to inform your healthcare provider of the medications you are taking, or planning to take, while on lanreotide treatment.