Treatment of acromegaly (when the secretion of growth hormone does not return to normal after surgery and / or radiotherapy). Treatment of clinical carcinoid symptoms. Treatment of primary pituitary adenomas responsible for hyperthyroidism - preparation for surgical procedures and / or radiotherapy or their supplementation and cases where the mentioned methods are not recommended.
Composition:
1 vial corresponds to 30 mg of lanreotide in the form of acetate.
Action:
Lanreotide (analogue of the natural hormone somatostatin) is a peptide inhibitor of some endocrine, exocrine, neuroendocrine and paracrine activities. It has high affinity for peripheral somatostatin receptors (pituitary and pancreatic), while its affinity for central receptors is much lower. These properties affect the secretion of growth hormone and digestive hormones. Lanreotide works stronger and longer than natural somatostatin. It selectively influences the secretion of growth hormone (treatment of acromegaly), but does not affect the secretion of insulin. The inhibitory effect on exocrine activity in the gut, digestive hormones and cell proliferation mechanisms is beneficial in treating the symptoms of gastrointestinal tumors that display endocrine activity (especially in the treatment of carcinoid). As a result of inhibition of tyrosotropic hormone synthesis (TSH), lanreotide normalizes thyroid function in patients with adenomas that secrete thyroid hormone. The kinetics of absorption of lanreotide, administered intramuscularly, is characterized by the occurrence of the first phase of rapid drug release, corresponding to the release of the peptide surface-bound microspheres and then the second phase of release, during which the concentration of the drug in the blood decreases slowly. The first maximum plasma concentration: (Cmax1: 6.8 +/- 3.8 μg / l) occurs within 1.4 +/- 0.8 h, while the second (Cmax2: 2.5 +/- 0.9 μg / l) in 1.9 +/- 1.8 days. The absolute bioavailability is 46.1 +/- 16.7%. The average residence period is 8 +/- 1 days, T0,5 it is 5.2 +/- 2.5 days. There is no evidence of drug accumulation when repeatedly administered over several months.
Contraindications:
Hypersensitivity to lanreotide and other ingredients. Pregnancy and breastfeeding.
Precautions:
Use with caution in diabetes, liver or kidney failure. In non-diabetic patients, there may be transient increases in blood Glucose that do not require insulin therapy.
Pregnancy and lactation:
The preparation is contraindicated in pregnancy and breast-feeding. Patients should be warned about the risk of fertility problems and the need to use contraception during treatment and for 3 months after discontinuation of the medicine.
Side effects:
Moderate, transient pain at the injection site, sometimes with local redness and thickening of the skin. Gastrointestinal symptoms: diarrhea or loose stools, abdominal pain or a feeling of heaviness in the abdomen, nausea, vomiting, anorexia nervosa. Rare cases of glucose disturbances have been observed. During long-term treatment, asymptomatic cholelithiasis was observed in some patients.
Dosage:
Intramuscularly. Considering the different susceptibility of tumors to somatostatin analogs, it is recommended to start treatment with a test injection, to evaluate the reaction (GH secretion, carcinoid symptoms, tumor secretion). If no response to intramuscular injection is observed, the intended use of the preparation should be considered. Acromegaly treatment: initially 30 mg every 14 days, in the case of inadequate response, assessed on the basis of GH and IGF-1 concentrations, the frequency of administration can be increased to 30 mg every 10 days. Use in carcinoid: initially 30 mg every 14 days, in the case of an inadequate response, assessed on the basis of clinical symptoms (flush to the head, loose stools), the frequency of administration can be increased to 30 mg every 10 days. Use in primary pituitary adenomas responsible for hyperthyroidism: initially 30 mg every 14 days.In the case of insufficient response to the drug, assessed on the basis of thyroid hormone and TSH, the frequency of drug administration can be increased to one 30 mg injection every 10 days.
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