Dosing & Uses
Dosage Forms & Strengths
injection solution
- 60mg/0.2mL
- 90mg/0.3mL
- 120mg/0.5mL
Acromegaly
Indicated for acromegaly in patients with failed or contraindicated radiation/surgery
90mg SC q4Week for 3 months; THEN adjust based on GH and/or IGF-1 levels
Dose adjustments after 3 months
- GH >1 to ≤2.5 ng/mL, IGF-1 normal and clinical symptoms controlled: Maintain dose at 90 mg q4Week
- GH >2.5 ng/mL, IGF-1 elevated and/or clinical symptoms uncontrolled: Increase dose to 120 mg q4Week
- GH ≤1 ng/mL, IGF-1 normal and clinical symptoms controlled: Reduce dose to 60 mg q4Week
- Patients controlled on 60-90 mg q4Week may be considered for an extended dosing interval of 120 mg q6-8Week
Gastroenteropancreatic Neuroendocrine Tumors
Indicated for unresectable, well-or moderately-differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) to improve progression-free survival
120 mg SC q4Week
Carcinoid Syndrome
Indicated for carcinoid syndrome
120 mg SC q4Week
Dosage Modifications
Renal impairment
Acromegaly
- Mild: Safety and efficacy not established
- Moderate-severe: 60 mg deep SC q4Week for 3 months initially; adjust based on GH and/or IGF-I levels thereafter
Gastroenteropancreatic neuroendocrine tumors
- Mild-moderate: No dosage adjustment necessary
- Moderate-severe: Safety and efficacy not established
Hepatic impairment
- Gastroenteropancreatic neuroendocrine tumors: Safety and efficacy not established
Acromegaly
- Mild: Safety and efficacy not established
- Moderate-severe (Child Pugh B or C): 60 mg deep SC q4Week for 3 months initially; adjust based on GH and/or IGF-I levels thereafter
Safety and efficacy not established
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Adverse Effects
>10%
Abdominal pain (19%)
Cholelithiasis (20%)
Diarrhea (57%)
Nausea (11%)
Bradyarrhythmia (5% to 18% )
Injection site reaction (subcutaneous depot, 6% to 22% ; intramuscular, up to 50% )
Flatulence (up to 14% )
Anemia (3% to 14% )
1-10%
Arthralgia (7%)
Constipation (8%)
Headache (7%)
Loose stools (6%)
Vomiting (7%)
Hyper-/hypoglycemia/diabetes (7%)
Sinus bradycardia (3%)
<1%
Injection site pruritus
Steatorrhea
Aortic valve regurgitation
Allergic skin reaction
Mitral valve regurgitation
Pancreatitis
Postmarketing Reports
Angioedema
Anaphylaxis
Gastrointestinal disorders: Abdominal pain, diarrhea, and steatorrhea
Hepatobiliary disorders: Cholecystitis, pancreatitis
General disorders and administration site conditions: Injection site reactions
Cardiac: Hypertension
Injection site reacsions: Injection site abscess
Warnings
Contraindications
Hypersensitivity to lanreotide
Cautions
Risk of reducing gallbladder motility, which could lead to gallstone formation; monitor periodically
Inhibition of insulin and glucagon secretion; may affect glucose regulation, which can lead to hyper-hypoglycemia; glucose monitoring is recommended; adjust antidiabetic treatment accordingly
Decreases in thyroid function reported; thyroid function tests are recommended where clinically indicated
Bradycardia, hypertension, and sinus bradycardia reported; use with caution in at-risk patients; initiate appropriate medical management in patients who develop symptomatic bradycardia
Pharmacological gastrointestinal effects of lanreotide may reduce the intestinal absorption of concomitant drugs; lanreotide may decrease the relative bioavailability of cyclosporine; concomitant administration of lanreotide and cyclosporine may necessitate the adjustment of cyclosporine dose to maintain therapeutic levels
Cholelithiasis (gallstones) resulting in complications, including cholecystitis, cholangitis, and pancreatitis, and requiring cholecystectomy reported; if complications of cholelithiasis are suspected, discontinue therapy and treat appropriately
Use caution in renal/hepatic impairment, diabetes
Pregnancy & Lactation
Pregnancy
Limited available data based on postmarketing case reports, use in pregnant women are not sufficient to determine a drug-associated risk of adverse developmental outcomes
A reproductive study in pregnant rats given 30 mg/kg of lanreotide by subcutaneous injection every 2 weeks (5 times the human dose, based on body surface area comparisons) resulted in decreased embryo/fetal survival
Lactation
There is no information available on presence of lanreotide in human milk, effects of drug on breastfed infant, or on milk production; studies show that lanreotide acetate administered subcutaneously passes into the milk of lactating rats; due to specifies-specific differences in lactation physiology, animal data may not reliably predict drug levels in human milk
Because of potential for serious adverse reactions in breastfed infants, including effects on glucose metabolism and bradycardia, advise women not to breastfeed during treatment and for 6 months (6 half-lives) following the last dose
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Analog of somatostatin, which is a peptide inhibitor of multiple endocrine, neuroendocrine, and exocrine mechanisms
Absorption
Peak plasma concentration (single dose): 3.8 ng/mL (60 mg-dose); 5.7 ng/mL (90 mg-dose); 7.7 ng/mL (120 mg-dose)
Peak plasma time: 7-12 hr
Distribution
Protein binding: 79-83%
Vd: 0.2 L/kg
Bioavailability: ~69-83%
Metabolism
Half-Life: 23-36 days
Excretion: Urine (<5%); feces (<0.5%)
Administration
SC Preparation
Remove lanreotide from refrigerator 30 minutes prior to administration; allow to come to room temperature
Visually inspect injection for particulate matter and discoloration
Do not administer if particulate matter or discoloration is observed
SC Administration
Administer as a deep SC injection only in the superior external quadrant of the buttock
Alternate the injection site between the right and left sides from one injection to another
Storage
Store in refrigerator at 2-8°C (36- 46°F)
Protect from light
Store in the original package
Images
Patient Handout
Formulary
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