Lanreotide
Lanreotide (Somatuline)
Lanreotide is a synthetic octapeptide analog of somatostatin, primarily used as a prescription medication for the treatment of acromegaly, gastroenteropancreatic neuroendocrine tumors (GEP-NETs), and carcinoid syndrome. It is formulated as Somatuline Depot (lanreotide acetate) for deep subcutaneous injection and provides sustained release over 4 weeks. Clinically, it suppresses growth hormone and IGF-1 secretion and inhibits tumor growth in neuroendocrine malignancies.
Mechanism of Action
Lanreotide binds with high affinity to somatostatin receptors, particularly SSTR2 and SSTR5, which are G-protein coupled receptors that inhibit adenylate cyclase and reduce intracellular cAMP. This receptor activation suppresses the secretion of growth hormone from the pituitary, as well as insulin, glucagon, and various gastrointestinal hormones. In neuroendocrine tumors, SSTR2 binding also exerts antiproliferative effects through inhibition of MAPK and PI3K/Akt signaling pathways and promotion of apoptosis.
Evidence by Health Goal(15 goals)
Dosing Protocols
Deep subcutaneous injection into the upper outer quadrant of the buttock; rotate injection sites
Starting dose for acromegaly is typically 90mg every 4 weeks for 3 months, then titrated based on GH/IGF-1 levels. For GEP-NETs, 120mg every 4 weeks is standard. Must be administered by a healthcare professional or trained patient/caregiver. Product must be refrigerated and allowed to reach room temperature before injection.
Safety & Side Effects
Lanreotide is a prescription-only medication in all major jurisdictions with a generally well-characterized safety profile when used under medical supervision; however, long-term use carries significant risks including gallbladder disease, glucose dysregulation, and cardiac effects requiring routine monitoring. It is contraindicated in pregnancy and requires careful dose adjustment in patients with hepatic impairment.
Possible Side Effects
- !Diarrhea and loose stools (most common, affects up to 37% of patients)
- !Abdominal pain and flatulence
- !Injection site reactions including pain, nodules, and induration
- !Cholelithiasis (gallstone formation) with long-term use
- !Bradycardia and other cardiac conduction abnormalities
- !Hyperglycemia or hypoglycemia due to altered insulin and glucagon secretion
- !Fatigue and headache
- !Hypothyroidism with prolonged treatment
Interactions
- -May reduce oral bioavailability of cyclosporine - therapeutic drug monitoring required
- -Can potentiate hypoglycemic effects of insulin and oral antidiabetics - blood glucose monitoring essential
- -May decrease absorption of concomitant oral medications due to slowed GI transit - timing of administration matters
- -Can enhance bradycardia with beta-blockers, calcium channel blockers, or other antiarrhythmics
- -May alter pharmacokinetics of bromocriptine - combined use in acromegaly requires monitoring
Cost & Where to Buy
Somatuline Depot is an extremely high-cost prescription biologic; list price in the US ranges from approximately $5,000–$11,000 per 120mg prefilled syringe (one month supply). Insurance coverage through Medicare Part B or private insurance is typical for approved indications. Patient assistance programs through Ipsen may reduce out-of-pocket costs significantly for eligible patients.
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