Why do I experience persistent hunger and occasional diarrhea 3-4 times a day after taking lanreotide (Somatuline)?

From the Guidelines

You should discuss adjusting your lanreotide dosage or adding supportive medications with your healthcare provider to manage the hunger and diarrhea symptoms. Feeling hungry all day after taking lanreotide while experiencing occasional diarrhea 3-4 times per day is likely due to the medication's effects on your digestive system and nutrient absorption. Lanreotide, a somatostatin analog used to treat certain neuroendocrine tumors, can cause both increased hunger and diarrhea as side effects, as it may affect blood sugar levels and gut hormone regulation, which can contribute to increased appetite 1. Some key points to consider:

• The diarrhea you're experiencing may be causing rapid transit of food through your digestive system, leading to decreased nutrient absorption and triggering hunger signals.
• Lanreotide can be administered at 60 mg qd im every 4 weeks, but the dosage might need to be adjusted based on your response to the treatment and the severity of the side effects 1.
• To manage these symptoms, consider eating smaller, more frequent meals with higher protein content to promote satiety, staying well-hydrated to replace fluids lost through diarrhea, and discussing anti-diarrheal medications with your doctor.
• Consuming foods with soluble fiber may help slow digestion and improve nutrient absorption. It's essential to report these persistent side effects to your healthcare provider, as they might consider adjusting your treatment plan to help manage these symptoms and improve your quality of life.

From the FDA Drug Label

Lanreotide inhibits the basal secretion of motilin, gastric inhibitory peptide, and pancreatic polypeptide, but has no significant effect on the secretion of secretin Lanreotide inhibits postprandial secretion of pancreatic polypeptide, gastrin, and cholecystokinin (CCK). In healthy subjects, lanreotide produces a reduction and a delay in postprandial insulin secretion, resulting in transient, mild glucose intolerance Lanreotide inhibits meal-stimulated pancreatic secretions, and reduces duodenal bicarbonate and amylase concentrations, and produces a transient reduction in gastric acidity.

The hunger you are experiencing after taking lanreotide may be related to the drug's effect on glucose intolerance and inhibition of pancreatic secretions. The diarrhea could be a result of the reduction in duodenal bicarbonate and amylase concentrations. However, the exact relationship between lanreotide and hunger is not explicitly stated in the label. 2 2

From the Research

Possible Causes of Hunger and Diarrhea

• Lanreotide, a somatostatin analogue, can affect gastrointestinal secretions and motility, potentially leading to diarrhea 3
• The medication may also impact glucose and lipid levels, which could contribute to feelings of hunger 4
• However, the relationship between lanreotide and hunger is not explicitly stated in the provided studies

Diarrhea as a Side Effect

• A study on lanreotide Autogel in the treatment of idiopathic refractory diarrhea found that the medication decreased symptoms in patients with chronic idiopathic refractory diarrhea 3
• Another study reported that lanreotide was well-tolerated in patients with congenital hyperinsulinism, but common side effects included subcutaneous nodules and gallstones, with no mention of diarrhea 5
• The frequency and severity of diarrhea in patients taking lanreotide may vary depending on the individual and the specific condition being treated

Impact on Glucose and Lipid Levels

• A study on lanreotide autogel 120 mg in treatment-naïve patients with acromegaly found that glucose and lipid levels were not detrimentally affected in most patients, but a small proportion showed deterioration in glucose control 4
• Another study reported that lanreotide resulted in a longer duration of fasting and a simplification of treatment regimens in patients with congenital hyperinsulinism 5
• The effects of lanreotide on glucose and lipid levels may contribute to feelings of hunger, but the exact relationship is not clearly established in the provided studies

Lanreotide as a Treatment

• Lanreotide has been used to treat various conditions, including congenital hyperinsulinism, idiopathic refractory diarrhea, and acromegaly 5, 3, 4
• The medication has shown efficacy in reducing symptoms and improving treatment regimens in these conditions, but its impact on hunger and diarrhea may vary depending on the individual and the specific condition being treated 5, 3, 4