Lanreotide

SOMATULINE

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Pronunciation: lan-REE-oe-tide

Lanreotide ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Lanreotide ballicule

What it isLong-acting somatostatin-receptor agonist; acromegaly and neuroendocrine tumors.

Why this oneIts deep-subcutaneous prefilled syringe can be administered at home, unlike intramuscular octreotide depot.

What limits itGallstones, glucose dysregulation, and injection-site nodules limit use; it suppresses insulin as well as growth hormone.

Lanreotide molecular structure (skeletal formula) — Molecular structure: Lanreotide

FDA-approved for

acromegaly/NETs (2007)

FDA label

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FDA dosing	Population	Start	Target	Max
Acromegaly	Adults	90 mg SC q4wk ×3 months	Adjust by GH/IGF-1 (60-120 mg q4wk)	120 mg q4wk
GEP-NETs	Adults	120 mg SC q4wk	120 mg q4wk	120 mg q4wk
Carcinoid syndrome	Adults	120 mg SC q4wk	120 mg q4wk	120 mg q4wk

Titration After 3 months, adjust acromegaly dose based on GH and/or IGF-1 levels

Renal Reduce starting dose in moderate/severe renal impairment (acromegaly) — see PI

Hepatic Reduce starting dose in moderate/severe hepatic impairment (acromegaly) — see PI

Do not give an additional carcinoid-syndrome dose if patient is already treated with lanreotide for GEP-NET

Instructions

Deep subcutaneous injection only, by a healthcare provider, into superior external quadrant of buttock; alternate sides
Remove from refrigerator 30 min before use; inspect for particulates/discoloration

Available strengths

inj 60 mg/0.2 mL
inj 90 mg/0.3 mL
inj 120 mg/0.5 mL

Cautions

Cholelithiasis and complications (monitor)
Hyperglycemia and hypoglycemia (monitor glucose)
Cardiovascular abnormalities (bradycardia)
Thyroid function decrease
Steatorrhea and malabsorption of dietary fats

Adverse reactions

Diarrhea
Cholelithiasis
Abdominal pain
Nausea
Injection site reactions

Pregnancy Limited data; animal studies show decreased embryo/fetal survival

Lactation Unknown in human milk; advise not to breastfeed during treatment and for 6 months after last dose

Cost

Lanreotide (SOMATULINE)

Strength		#/mo	CostPlus
60 mg/0.2 mL	inj	per unit	not offered
90 mg/0.3 mL	inj	per unit	not offered
120 mg/0.5 mL	inj	per unit	not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Lanreotide is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryBy 2023

NO BOXED WARNINGS

Principal riskGallstones with prolonged use

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryUnknown / historical label unavailable

Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.

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