From the FDA Drug Label
DOSAGE AND ADMINISTRATION Administration (2.1): For deep subcutaneous injection only. Intended for administration by a healthcare provider. Administer in the superior external quadrant of the buttock. Alternate injection sites. Recommended Dosage (2.1) Acromegaly: 90 mg every 4 weeks for 3 months. Adjust thereafter based on GH and/or IGF-1 levels. See full prescribing information for titration regimen. GEP-NETs: 120 mg every 4 weeks. Carcinoid Syndrome: 120 mg every 4 weeks. The typical dose for lanreotide administered subcutaneously for carcinoid syndrome (which may be related to carcinoid heart disease) is 120 mg every 4 weeks 1.
From the Research
For carcinoid heart disease, lanreotide is typically administered subcutaneously at a dose of 120 mg every 4 weeks. This recommendation is based on the most recent and highest quality study available, which demonstrated the efficacy and safety of lanreotide in controlling symptoms associated with carcinoid syndrome, a condition that can contribute to cardiac complications 2. The medication should be injected deep subcutaneously in the superior external quadrant of the buttock or the upper outer thigh, rotating injection sites. Before administration, the medication should be removed from the refrigerator and allowed to reach room temperature (approximately 30 minutes). Lanreotide works by inhibiting the secretion of serotonin and other vasoactive substances from carcinoid tumors, which can cause fibrotic changes in heart valves leading to carcinoid heart disease.
Some key points to consider when administering lanreotide include:
- Monitoring patients regularly for symptom control and potential side effects, which may include injection site reactions, gastrointestinal disturbances, and gallstones.
- Dose adjustments may be necessary based on symptom control and tolerability.
- Some patients with severe symptoms might require more frequent dosing, but this should be determined by a specialist.
- The use of lanreotide has been shown to be effective in reducing the frequency of short-acting octreotide rescue therapy, which is a surrogate marker for symptom control 2.
- The medication has been well-tolerated in clinical trials, with no new safety concerns identified 2.
It's worth noting that while the study by 3 provides valuable insights into the management of carcinoid heart disease, it does not directly inform the dosing of lanreotide. However, it does highlight the importance of monitoring patients with carcinoid syndrome for cardiac complications and adjusting treatment accordingly. Overall, the available evidence supports the use of lanreotide at a dose of 120 mg every 4 weeks for the management of carcinoid heart disease.