lanreotide


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lanreotide

(lan-ree-o-tide) ,

Somatuline Depot

(trade name)

Classification

Therapeutic: hormones
Pharmacologic: somatostatin analogues
Pregnancy Category: C

Indications

Long-term management of acromegaly which cannot be treated by or has not responded to surgery and/or radiation therapy.

Action

Acts as an analog of somatostatin, inhibiting growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in patients with acromegaly.

Therapeutic effects

Decreased levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) in acromegalic patients resulting in decreased manifestations of acromegaly.

Pharmacokinetics

Absorption: Following subcut administration, lanreotide precipitates in body tissues acting as a depot formulation from which drug is slowly released (75% bioavailability).
Distribution: Unknown.
Metabolism and Excretion: Minimal renal/fecal excretion, some biliary excretion.
Half-life: 23–30 days.

Time/action profile

ROUTEONSETPEAKDURATION
Subcutunknownfirst 24 hr1 mo

Contraindications/Precautions

Contraindicated in: Obstetric: Lactation.
Use Cautiously in: Diabetic patients; Underlying heart disease, especially bradycardia; Obstetric: Use only if maternal benefit outweighs risk to fetus; Pediatric: Safety not established.

Adverse Reactions/Side Effects

Cardiovascular

  • bradycardia
  • hypertension

Gastrointestinal

  • pancreatitis (life-threatening)
  • abdominal pain (most frequent)
  • diarrhea (most frequent)
  • gallstones (most frequent)

Endocrinologic

  • hyperglycemia
  • hypoglycemia

Hematologic

  • anemia

Local

  • injection site reactions (most frequent)

Interactions

Drug-Drug interaction

↑ risk of bradycardia with other drugs that may cause ↓ heart rate including beta-blockers.May ↓ absorption of cyclosporine (dose adjustment may be necessary).May alter the effects of antidiabetic agents (monitor blood sugar).May ↓ activity or CYP450 enzyme system, use cautiously with drugs metabolized by that system, including quinidine.

Route/Dosage

Subcutaneous (Adults) 90 mg every 4 week for 3 mo, further adjustments are made on the basis of GH and IGF1 levels as follows: GH > 1 to ≤2.5 ng/mL, IGF-1 normal with good symptom control—maintain dose at 90 mg every 4 wk;GH >2.5 ng/mL, IGF-1 elevated and/or uncontrolled symptoms—↑ dose to 120 mg every 4 wk; GH ≤1 mg/mL, IGF-1 symptoms currently controlled —↓ dose to 60 mg every 4 wk.

Hepatic/Renal Impairment

Subcutaneous (Adults) Moderate to severe hepatic or renal impairment—60 mg every 4 wk; further adjustments are made on the basis of GH and IGF1 levels.

Availability

Semi-solid in pre-filled syringes: 60 mg, 90 mg, 120 mg

Nursing implications

Nursing assessment

  • Assess for GI side effects (diarrhea, abdominal pain, nausea, gas, constipation); usually decrease with continued treatment.
  • Lab Test Considerations: Monitor serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels every 3 mo.
    • May cause hyperglycemia or hypoglycemia. Monitor blood glucose when therapy is initiated and when dose is altered and adjust antidiabetic treatment accordingly.
    • May cause slight ↓ thyroid function; monitor as clinically indicated.
    • May cause anemia.

Potential Nursing Diagnoses

Risk for disproportionate growth (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Subcutaneous: Store in refrigerator and protect from light. Remove sealed pouch from refrigerator 30 min prior to injection; allow to reach room temperature. Keep pouch sealed until injection. Administer deep into subcutaneous tissue of superior external buttock. Do not fold skin; insert needle perpendicular to skin, rapidly to full length. Alternate injection between right and left side. May cause injection site reactions (pain, injection site mass); decrease with continued therapy. Syringe is for single use; do not use after expiration date.

Patient/Family Teaching

  • Explain purpose of lanreotide to patient. Advise patient to read Patient Information before receiving first injection and before each monthly injection in case of new information. If an injection is missed, consult health care professional.
  • Instruct patient to notify health care professional if unusual symptoms develop or known symptoms persist or worsen.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
  • Advise patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Decreased levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1).

lanreotide

an antigrowth hormone.
indication This drug is used to treat acromegaly in patients having an inadequate response to other treatments.
contraindications Known hypersensitivity to this drug or latex allergy prohibits its use.

lanreotide

A somatostatin analogue drug used to treat the growth disorder acromegaly prior to surgery on the pituitary gland. Somatostatin is a hormone produced by the hypothalamus of the brain, which inhibits the release of the natural growth hormone, somatotropin as well as of other pituitary gland-stimulating hormones. Brand name: Somatuline LA.
References in periodicals archive ?
He also highlighted the efficacy of Lanreotide in acromegaly besides monotherapy with SSA.
Contract notice: conclusion of non-exclusive discount agreements pursuant to section 130a (8) sgb v on medicines containing the active substance lanreotide (atc: h01cb03) as part of a so-called open-house model.
The combination of docetaxel and the somatostatin analogue lanreotide on androgen-independent docetaxel-resistant prostate cancer: experimental data.
Use of SSTR2- and SSTR5-preferring OCT and lanreotide may be a useful treatment for TSHoma.
Somatuline's active substance, lanreotide acetate, is a somatostatin analogue that inhibits the secretion of several endocrine, exocrine and paracrine functions.
Effect of a six-month treatment with lanreotide on cardiovascular risk factors and arterial intima-media thickness in patients with acromegaly.
Therefore longer-acting somatostatin-analogs, such as octreotide and lanreotide have been developed [12].
90) tratamentos para acromegalia, sendo um com somatostatina analoga octreotide LAR e outro com somatostatina analoga lanreotide.
Ultrasonographic evidence of joint thickening reversibility in acromegalic patients treated with lanreotide for 12 months.
The International Lanreotide and Interferon Alfa Study Group.
No se ha demostrado asociacion de este tipo de lesiones con el tratamiento, especificamente de la cabergolina (10), aunque menos utilizada luego del advenimiento de los analogos de somatostatina (11), los pacientes recibieron en este caso octreotide, lanreotide y somavert.