Lanreotide (Somatuline)

These instructions are for Children's Hospital of Philadelphia (CHOP) patients with hyperinsulinism (HI) who are prescribed lanreotide to manage low blood sugar, also called hypoglycemia.

Important information:

• Learn more about hyperinsulinism.

• Lanreotide, also known by the brand name Somatuline®, works by decreasing the amount of insulin released into the body.

• The medicine is given by an injection underneath the skin, deep into the fatty tissue. This type of injection is also called deep subcutaneous (SC). To reduce the pain, a numbing cream is applied to the skin before giving the injection.

• Lanreotide comes in different doses: 60 mg, 90 mg or 120mg. Check the dose of the medicine each time you refill the prescription.

• Contact your healthcare team if your child has any of the side effects below.

• Common side effects of lanreotide include:

  • Pain or hardened bumps at injection site

  • Changes in blood sugar levels

  • Diarrhea

  • Nausea/vomiting

  • Stomach pain

  • Bloating/gas pain

  • Muscle pain

  • Headache

  • Dizziness

  • Anemia, which is a when your body makes fewer red-blood cells

  • Gallstones

  • Slowed growth

• Less common side effects can include:

  • Severe allergic reaction

  • Decreased thyroid gland activity

  • Inflammation of the pancreas

  • Gallbladder or liver problems

  • Fatty stools

• Before going home, your team will teach you:

  • Your child's dose of lanreotide

  • Whether you will be giving the injection at home or going to a doctor's office

  • How to give the injection

  • How to check your child's blood sugar

  • How to give glucagon injections in a low-blood sugar emergency

Patient instructions before giving the injection:

Gather supplies:

• 
  Caution: Keep medicine and supplies out of the reach of children

  Numbing medicine

• Alcohol swabs

• Gauze

• Band-Aid (if your child wants one)

• Hard plastic container for disposal of used syringes

• Medicine in the pre-filled syringe with needle

Prepare the medicine:

• Take the package out of the refrigerator 30 minutes before you give the injection to your child. The medicine should be at room temperature.

• Keep this medicine out of the light. Do not open the foil pouch until you are ready to give the medicine to your child.

Prepare your child for the injection:

• Approach your child in a calm, but firm manner.

• Have someone hold your child while you give the injection.

• If your child is old enough to understand, explain why the injection is needed. You may need to explain this every time you give the injection.

• Distract your child with a pacifier, a toy, a movie, a book, by squeezing a hand or an object, or in any way that may be helpful.

• Explain to your child that it is okay to cry, but they must be still.

• Do not expect your child to adjust to receiving the injection.

Instructions for giving the injection:

1. Wash and dry your hands well or use hand sanitizer.

2. Select the right or left buttock for the injection site. Switch sides with each injection.
   

3. Apply numbing medicine 30 minutes before giving the injection.

4. Read the label on the medicine and check the label for:

   • Your child's name

   • Name of the medicine

   • Dose

   • Amount of medicine in the syringe

   • Expiration date

5. Remove the medicine syringe from the packaging and place on a clean surface.

6. Have your child lie flat on their belly.

7. Wipe the numbing medicine off with gauze.

8. Wipe the injection site with alcohol and let dry.

9. Remove needle cap. Throw it away.

10. Spread the skin at the injection site to make it tight.

11. Hold the syringe like a pencil. Quickly insert the needle straight through the skin on the buttock at a 90-degree angle. Your team will teach you how far to insert the needle. This will depend on how much fatty tissue your child has.

12. Slowly push the plunger all the way down until you hear a click. The medicine is thick so you cannot push it in quickly.

13. Hold the plunger in place for ten seconds.

14. While holding the plunger down with your thumb, pull the needle out of the skin.
    

15. When the needle is out of the skin, remove your thumb. The needle will pull back into the protective cover on its own.
    

16. Place gauze over the site for a few seconds but do not rub the area.

17. Cover site with a Band-Aid if you wish.

18. Comfort your child.

19. Dispose of the syringe in a hard container such as needle box or laundry detergent bottle. Contact your township refuse department to find out how to dispose of the container or visit SafeNeedleDisposal.org.

Call your CHOP healthcare team with any question, concerns or if your child:

• Is vomiting often

• Has stomach pain

• Has blood sugar less than 70 mg/dl, that has not come up after treatment

Division of Endocrinology and Diabetes

Reviewed on January 18, 2023, by Heather McKnight, CRNP; Nicole Stewart, RN; Jaime Gomes, PharmD