From the Guidelines
Diarrhea from lanreotide is typically temporary for most patients. This side effect commonly occurs during the initial treatment phase and tends to improve or resolve completely as the body adjusts to the medication. According to the NCCN guidelines insights: neuroendocrine and adrenal tumors, version 2.2018 1, diarrhea is a notable side effect, but the guidelines focus more on the management of persistent diarrhea with telotristat for patients with carcinoid syndrome, implying that not all diarrhea is persistent. About 30-40% of patients experience diarrhea when starting lanreotide, but it usually subsides within 2-4 weeks of continued treatment. If you're experiencing diarrhea while taking lanreotide, stay well-hydrated and consider a low-fat diet temporarily, as lanreotide affects fat absorption. Over-the-counter antidiarrheal medications like loperamide can help manage symptoms if needed. However, if diarrhea is severe, persistent beyond a month, or accompanied by dehydration, contact your healthcare provider, as dose adjustments might be necessary. Lanreotide causes diarrhea by altering gut motility and digestive enzyme secretion, which is part of how it works to control hormone levels, but your digestive system typically adapts to these changes over time. Key points to consider include:
- Staying hydrated
- Temporary dietary adjustments
- Potential use of antidiarrheal medications
- Monitoring for severe or persistent diarrhea that may require medical intervention, as suggested by the management strategies for carcinoid syndrome in the NCCN guidelines 1.
From the FDA Drug Label
The most commonly reported adverse reactions reported by greater than 5% of patients who received SOMATULINE DEPOT (N=416) in the overall pooled safety studies in acromegaly patients were gastrointestinal disorders (diarrhea, abdominal pain, nausea, constipation, flatulence, vomiting, loose stools) Steatorrhea and Malabsorption of Dietary Fats New onset steatorrhea, stool discoloration and loose stools have been reported in patients receiving somatostatin analogs, including SOMATULINE DEPOT Somatostatin analogs reversibly inhibit secretion of pancreatic enzymes and bile acids, which may result in malabsorption of dietary fats and subsequent symptoms of steatorrhea, loose stools, abdominal bloating, and weight loss
The FDA drug label does not explicitly state that diarrhea is temporary when taking lanreotide. However, it does mention that somatostatin analogs, including lanreotide, reversibly inhibit secretion of pancreatic enzymes and bile acids, which may result in malabsorption of dietary fats and subsequent symptoms of steatorrhea, loose stools, abdominal bloating, and weight loss. This suggests that the gastrointestinal effects, including diarrhea, may be reversible. However, the label does not provide information on the duration of diarrhea. 2 2
From the Research
Diarrhea and Lanreotide
- Diarrhea is a common symptom in various medical conditions, and its relationship with lanreotide, a somatostatin analogue, has been studied in several clinical trials 3, 4, 5.
- Lanreotide has been shown to decrease symptoms of diarrhea in patients with chronic idiopathic refractory diarrhea 3 and in patients with neuroendocrine tumors 4.
- In the study by 3, lanreotide Autogel 120 mg decreased the mean number of stools from 5.7 to 3.7 at day 56, and 42.4% of patients had a response to lanreotide Autogel at day 28.
- Another study by 4 found that lanreotide depot/autogel significantly reduced the need for short-acting octreotide for symptomatic carcinoid syndrome control in neuroendocrine tumor patients, and patient-reported symptom data showed improved diarrhea control during double-blind and open-label treatment.
Temporary Nature of Diarrhea with Lanreotide
- The temporary nature of diarrhea when taking lanreotide is not explicitly stated in the provided studies, but the studies suggest that lanreotide can improve diarrhea symptoms in various patient populations 3, 4, 5.
- The study by 4 found that improved diarrhea control was sustained during maintenance of lanreotide treatment for 32 weeks, suggesting that the effect of lanreotide on diarrhea may not be temporary.
- However, the study by 5 reported that patients who switched from placebo to lanreotide in the open-label extension study experienced more diarrhea considered treatment-related, which may indicate that diarrhea can be a side effect of lanreotide treatment.