Somatuline Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Somatuline Injection contains lanreotide, an antigrowth hormone medicine (somatostatin analog) given as a long-acting injection under the skin. It is used to treat acromegaly, certain neuroendocrine tumours of the intestine and pancreas, and carcinoid syndrome in adults. It works by mimicking a natural body hormone to lower growth hormone and IGF-1 levels and reduce certain hormone release from the stomach and intestines.

What is Somatuline Injection

Somatuline is an injectable medicine containing lanreotide, a man-made version of a natural body hormone called somatostatin. It is given as a long-acting injection under the skin that slowly releases the medicine over several weeks.

Somatuline Injection uses

• Long-term treatment of adults with acromegaly (a condition caused by too much growth hormone) who have not responded well to or cannot have surgery or radiotherapy
• Relief of symptoms associated with acromegaly
• Treatment of certain neuroendocrine tumours of the intestine and pancreas (enteropancreatic/gastroenteropancreatic NETs) to slow tumour growth
• Treatment of adults with carcinoid syndrome, reducing the need for rescue medication

Benefits of Somatuline Injection

• Can lower growth hormone and IGF-1 levels in acromegaly, sometimes close to normal
• Can delay progression of certain intestinal and pancreatic tumours
• Can reduce the frequency of needing rescue medication for carcinoid syndrome symptoms like flushing and diarrhea
• Improvement or stabilization of symptoms such as headache, sweating, fatigue, swelling, and joint pain in acromegaly patients

How Somatuline Injection works

Lanreotide works like a natural body hormone called somatostatin. It helps lower growth hormone and IGF-1 levels and reduces the release of certain hormones from the stomach and intestines. It can also help slow or stop the growth of certain tumours in the intestine and pancreas.

Somatuline Injection dosage

Somatuline is given as a deep injection under the skin (subcutaneous) into the upper outer buttock or upper outer thigh. The injection site should be switched between the right and left sides each time. It may be given by a healthcare professional, a trained caregiver, or self-administered into the thigh after proper training.

Let the syringe warm up at room temperature before use, as injecting cold medicine may be painful. Do not rub or massage the injection site after the injection; apply gentle pressure with a dry cotton ball or gauze instead.

If a dose is missed, contact your healthcare professional as soon as possible for guidance on timing of the next dose. Do not give extra injections to make up for a missed one.

Available forms and strengths

• Extended release solution for injection in a pre-filled syringe (60 mg, 90 mg, 120 mg strengths)

Side effects of Somatuline Injection

Common

• Diarrhea
• Abdominal pain
• Nausea
• Vomiting
• Headache
• Dizziness
• Injection site reactions (pain, mass, itching, redness)
• Constipation
• Flatulence
• Weight decrease
• Hair loss
• Muscle or joint pain
• Fatigue
• Cold-like symptoms (cough, runny nose, sore throat, fever)

Serious

• Gallstones and gallbladder problems (sudden severe upper right abdominal pain, nausea, vomiting)
• High or low blood sugar (changes in thirst, urination, energy, dizziness, sweating, confusion)
• Slow heart rate (bradycardia)
• Underactive thyroid (hypothyroidism)
• Pancreatitis (severe abdominal pain spreading to the back, nausea, vomiting)
• Liver problems (yellowing skin/eyes, dark urine, abdominal pain, itching)
• Severe allergic reactions (swelling of face/lips/tongue, difficulty breathing, rash, dizziness)
• Pancreatic Exocrine Insufficiency (fatty stools, diarrhea, bloating, weight loss)
• Inflammation of the bile duct
• New tumour growth
• Hearing loss
• Depression

Warnings and precautions

• Somatuline is not recommended during pregnancy because it may harm an unborn baby. Women who could become pregnant should use contraception during treatment.
• Somatuline should not be used while breastfeeding, as it is not known if the drug passes into breast milk.
• People with moderate or severe kidney problems should start at a lower dose, as the body clears the drug more slowly.
• People with moderate or severe liver problems should start at a lower dose, since the drug is cleared more slowly from the body.
• Somatuline can cause headaches and dizziness, especially after the first dose or a dose increase, so caution should be used when driving or operating machinery.
• Somatuline can cause problems with blood sugar control, including low blood sugar in people with diabetes or high blood sugar.
• Somatuline can reduce gallbladder movement, which can lead to gallstones forming.
• Somatuline can interact with the drug cyclosporine, lowering its levels in the blood.
• Somatuline may slow the heart rate, especially in people with existing heart problems.
• Gallstone complications such as inflammation of the gallbladder, bile duct, or pancreas have been reported, sometimes requiring gallbladder removal surgery.
• Somatuline may cause a condition where the pancreas does not make enough digestive enzymes, leading to symptoms like oily stools and weight loss.
• Allergic reactions, including severe ones, have been reported with this medicine.

Storage

• Store under refrigeration (2 to 8°C) in its original package to protect from light
• Do not freeze
• Leave at room temperature for 30 minutes before administration
• Once removed from the refrigerator, product left in its sealed pouch may be returned to the refrigerator for continued storage and later use, provided it has been stored for no longer than a total of 72 hours at below 40°C (the number of temperature excursions must not exceed three times)
• Keep out of the reach and sight of children
• Do not use after the expiry date shown on the labels and box

When to see a doctor

• Get medical help right away if you have signs of a gallstone problem, such as sudden severe pain in the upper right abdomen, possibly with nausea and vomiting.
• Seek immediate medical help for signs of a severe allergic reaction, such as swelling of the face, lips, mouth, or tongue, difficulty breathing, or fainting.
• Get medical help right away for symptoms of pancreatitis, such as severe abdominal pain spreading to the back, with nausea, vomiting, and a fast heartbeat.
• Seek medical attention for signs of liver problems, such as yellowing of the skin or eyes, dark urine, and nausea.
• If you think you or someone you are caring for has taken too much Somatuline, contact a healthcare professional, hospital emergency department, or your regional poison control center immediately, even if there are no symptoms.

Alternatives

• Octreotide
• Sandostatin
• Sandostatin LAR