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Somatuline Depot 120mg Injection
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Indications & Clinical Uses
- Somatuline Depot (lanreotide acetate) 120 mg is a long-acting somatostatin analogue given as a deep subcutaneous injection from a single-dose, pre-filled syringe.
- In the United States it is approved for the long-term treatment of acromegaly in patients who have had an inadequate response to, or cannot have, surgery or radiotherapy, for the treatment of unresectable, well- or moderately-differentiated gastroenteropancreatic neuroendocrine tumours (GEP-NETs) to improve progression-free survival, and to reduce the frequency of rescue therapy for carcinoid syndrome.
- Somatuline Depot is the US brand name; the same lanreotide product is marketed in Europe and the UK as Somatuline, also called Somatuline Autogel or, more recently in the UK, Lanreotide Ipsen (see Sr 3169).
- Unlike the EU/UK product, Somatuline Depot's US label states it is intended for administration by a healthcare provider only, given in the upper outer buttock (gluteal) region every 4 weeks, alternating sides.
Side Effects
- The most common side effects of Somatuline Depot (lanreotide) in acromegaly, each affecting more than 1 in 10 people, are diarrhoea (37 to 48%), gallstones (20 to 27%), abdominal pain (about 20%) and injection-site reactions (9 to 17%); in GEP-NET studies, abdominal pain, musculoskeletal pain, vomiting, headache and hyperglycaemia were each reported in at least 14 to 34% of patients.
- Somatuline Depot carries no boxed warning.
- Watch for and report signs of gallstones, such as right-sided abdominal pain after fatty meals, pancreatitis (severe, constant stomach pain), a very slow heart rate, dizziness or fainting, and marked changes in blood sugar.
- Injection-site pain, lumps or hardness are common and usually settle on their own; tell your healthcare provider if a site becomes red, warm or swollen.
Precautions & Warnings
- Somatuline Depot is contraindicated in known hypersensitivity to lanreotide.
- Because it increases the risk of gallstones, periodic gallbladder ultrasound monitoring is recommended.
- Blood glucose should be monitored, particularly when starting treatment or changing doses, since lanreotide can cause either hyperglycaemia or hypoglycaemia and diabetes medicines may need adjusting.
- Heart rate should be monitored in people with bradycardia or conduction disorders, as somatostatin analogues can further slow the heart.
- Thyroid function testing is recommended during long-term treatment.
- Watch for symptoms of pancreatic exocrine insufficiency, such as pale, greasy, floating stools.
- Somatuline Depot is intended for administration by a healthcare provider only - it is not for self-injection under the US label - and must be given by deep subcutaneous injection into the gluteal region, never intravenously.
- Discuss pregnancy plans with your healthcare provider, since data on lanreotide use in human pregnancy are limited.
Avoid Interactions
- Ciclosporin absorption can be reduced by Somatuline Depot (lanreotide), so ciclosporin blood levels should be monitored and the dose adjusted as needed, particularly in transplant patients.
- Bromocriptine absorption may be increased.
- Because lanreotide can slow heart rate, use additional caution with beta-blockers, calcium-channel blockers or other bradycardia-inducing drugs.
- Insulin and oral antidiabetic medicine doses often need adjustment, since lanreotide can raise or lower blood glucose.
- Caution is advised with drugs that have a narrow therapeutic index and are metabolised through the CYP3A4 pathway.
- Tell your healthcare provider and pharmacist about every other prescription medicine, over-the-counter product and supplement you use before and during Somatuline Depot treatment.
References
Frequently Asked Questions
Somatuline Depot (lanreotide) is a long-acting injection used to treat acromegaly and certain neuroendocrine tumours (GEP-NETs), and to ease carcinoid syndrome symptoms. It is the US brand; the same lanreotide product is sold in Europe and the UK as Somatuline.
A healthcare provider gives Somatuline Depot as a deep injection under the skin of the buttock, once every 4 weeks, alternating sides each time. In the US it must be given by a healthcare professional; it is not a self-injected medicine.
The most common side effects of Somatuline Depot (lanreotide) are diarrhoea, gallstones, abdominal pain and injection-site reactions, each affecting more than 1 in 10 people. Report severe stomach pain, a very slow heartbeat, dizziness, or pale, greasy stools to your healthcare provider promptly.
Tell your healthcare provider before combining Somatuline Depot with ciclosporin, bromocriptine, beta-blockers or diabetes medicines, since lanreotide affects blood sugar and can change how these drugs work. It must never be given into a vein or muscle, and pregnancy plans should be discussed first.
While on Somatuline Depot, you'll have periodic gallbladder ultrasounds to check for gallstones, blood glucose checks, and thyroid function tests during long-term treatment. Your heart rate may also be checked if you have a history of a slow heartbeat or heart conduction problems.
Somatuline Depot and Somatuline contain the same medicine, lanreotide, at the same strengths, made by Ipsen. Somatuline Depot is the US brand and must be given by a healthcare professional; Somatuline is the EU/UK brand, which can sometimes be self-injected after training.
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