Drug Overview

Lanreotide (Somatuline Depot) is a long-acting somatostatin analog administered as a deep subcutaneous injection. It is FDA-approved for:

  • Treatment of acromegaly in patients with inadequate response to surgery/radiotherapy
  • Treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs)
  • Treatment of carcinoid syndrome

Patient Education Prior to Administration

Pre-Treatment Discussion Points

  • Purpose: Explain the specific indication for treatment and expected outcomes
  • Administration schedule: Typically every 4 weeks
  • Procedure details: Brief explanation of deep subcutaneous injection in the buttock
  • Pre-medication requirements: None routinely required

Potential Side Effects to Discuss

  • Common gastrointestinal effects: diarrhea, abdominal pain, nausea, constipation
  • Injection site reactions: pain, nodules, induration
  • Potential for gallstone formation with long-term use
  • Possible effects on blood glucose levels
  • Fatigue, headache, dizziness

Lifestyle Considerations

  • Monitoring blood glucose for diabetic patients
  • Possible need for periodic gallbladder ultrasounds
  • Follow-up laboratory monitoring schedule

Preparation and Storage

Storage Requirements

  • Store in original packaging in refrigerator (36°F to 46°F/2°C to 8°C)
  • Allow to reach room temperature for 30 minutes prior to administration
  • Do not refreeze or shake vigorously

Forward the video to 3:15 mark to view the injection procedure.

Preparation Steps

  1. Remove from refrigerator 30 minutes before administration
  2. Verify patient identity, medication, dose, and expiration date
  3. Inspect solution for particles or discoloration
  4. Keep needle cap on until immediately before injection
  5. No reconstitution required; product is supplied in a ready-to-use prefilled syringe

Administration Guidelines

Equipment Needed

  • Lanreotide prefilled syringe with safety system (60mg, 90mg, or 120mg)
  • Alcohol swabs
  • Gloves
  • Sharps container

Administration Technique

  1. Patient position: Have patient lie flat or stand with weight shifted to opposite leg of injection site
  2. Site selection: Superior external quadrant of the buttock
    • Alternate between right and left gluteal areas for repeated doses
    • Avoid areas with skin problems, bony prominences, or major blood vessels
  3. Injection technique:
    • Clean site with alcohol and allow to dry
    • Remove needle cap immediately before injection
    • Stretch or flatten the injection area
    • Insert entire needle perpendicular (90° angle) to the skin
    • Inject slowly and steadily (suggested time: approximately 20 seconds)
    • Do NOT aspirate
  4. Needle safety: Activate needle guard system immediately after injection
  5. Documentation: Record date, time, dose, site, and patient response

Critical Notes

  • Must be administered via DEEP subcutaneous injection only
  • Full needle length (20mm) should be inserted
  • Incorrect administration technique may result in decreased efficacy or increased adverse reactions

Management of Adverse Reactions

Mild to Moderate Reactions

  • Injection site reactions: Apply cool compress, rotate sites with future doses
  • Gastrointestinal symptoms: Anti-diarrheal medications as ordered, small frequent meals
  • Hypoglycemia/hyperglycemia: Monitor blood glucose, adjust antidiabetic medications as prescribed

Severe Adverse Reactions

  • Hypersensitivity reactions: Discontinue administration, implement anaphylaxis protocol if needed
  • Severe bradycardia: Monitor vital signs, have atropine available
  • Severe hypo/hyperglycemia: Follow facility protocol for glucose management

When to Contact Provider

  • Severe or persistent injection site reactions
  • Signs of gallbladder disease (right upper quadrant pain, nausea)
  • Significant changes in blood glucose levels
  • New or worsening cardiac symptoms
  • Severe, persistent gastrointestinal symptoms

Post-Administration Monitoring

Immediate Monitoring

  • Vital signs immediately after administration
  • Assessment of injection site
  • Monitor for 15-30 minutes for immediate adverse reactions

Long-term Monitoring

  • Laboratory monitoring:
    • Hormone levels (GH, IGF-1) for acromegaly patients
    • Liver function tests
    • Blood glucose levels
    • Thyroid function tests
  • Imaging: Periodic gallbladder ultrasounds
  • Clinical assessment: Symptom improvement and adverse effect evaluation

Documentation Requirements

  • Pre-administration assessment
  • Dose administered, lot number, expiration date
  • Injection site and technique
  • Patient tolerance and immediate response
  • Post-administration monitoring results
  • Patient education provided
Why Lanreotide Syringes Feel Clogged: Causes & Injection Tips
Lanreotide’s thick consistency often makes syringe plungers hard to press, especially if injected too quickly. Learn how viscosity, technique, device issues, and needle checks can prevent clogs and ensure smoother Somatuline Depot administration.
PharKeep DigestKevin Van, PharmD, BCPS (Editor)

References

  1. Ipsen Biopharmaceuticals, Inc. (2023). Somatuline Depot (lanreotide) injection prescribing information. Basking Ridge, NJ.
  2. Infusion Nurses Society. (2021). Infusion Therapy Standards of Practice. Journal of Infusion Nursing, 44(1S).
  3. National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors.