What is in this leaflet?
Please read this leaflet carefully. It provides some information about your medicine. If you have any questions or are not sure about anything after you have read this leaflet, please ask your doctor or pharmacist.
The name of your medicine is Somatuline® Autogel®. Somatuline Autogel is a solution for injection in a pre-filled syringe, ready to use and fitted with an automatic safety system. It is a white to pale yellow semi-solid formulation. The active substance is lanreotide. The dose of lanreotide you will receive is 60, 90 or 120 mg. There is an extra amount filled into the syringe to ensure that the correct dose can be injected. The other ingredients are sterile water and acetic acid.
The product is for single use only.
What is SOMATULINE AUTOGEL?
Somatuline Autogel is a prolonged release formulation of lanreotide. Lanreotide is an octapeptide, an analogue of a naturally occurring hormone, somatostatin. Lanreotide lowers the levels of hormones in the body such as GH (growth hormone) and IGF-1 (insulin-like growth factor-1).
What is SOMATULINE AUTOGEL used for?
Somatuline Autogel is used for the treatment of acromegaly when the circulating levels of growth hormone and IGF-1 remain abnormal after surgery and/or radiotherapy, or in patients who do not respond to therapy with drugs called dopamine agonists.
Somatuline Autogel is used for the treatment of symptoms associated with carcinoid syndrome, such as flushing and diarrhoea.
Somatuline Autogel is used for the treatment and control of the growth of some advanced tumours of the intestine and pancreas that cannot be removed by surgery (called gastroenteropancreatic neuroendocrine tumours or GEP-NETs).
Before you are given SOMATULINE AUTOGEL
When you must not be given it
Do not be given Somatuline Autogel if:
- you are breastfeeding
- you have a tumour blocking your intestines
- you are allergic to lanreotide, the active ingredient of Somatuline Autogel.
Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or tongue.
Before you are given it
Tell your doctor if:
- you are a diabetic
- you have ever experienced liver or kidney problems
- you have ever experienced gallstones, as Somatuline Autogel may lead to gallstone formation in the gallbladder. In this case, you may need to be monitored periodically. Your doctor may decide to stop treatment with Somatuline Autogel if complications arising from gallstones occur.
- you have any thyroid problems, as Somatuline Autogel may slightly decrease your thyroid function
- you have any heart problems, as sinus bradycardia (slow heart rate) may occur during Somatuline Autogel treatment. Special care should be taken by your doctor when first starting Somatuline Autogel if you have bradycardia.
- you are pregnant or think you may be pregnant
- you are breastfeeding.
Talk to your doctor or pharmacist during treatment:
- if you have fatty stools, loose stools, abdominal bloating or weight loss. These may be signs of pancreatic exocrine insufficiency (PEI), a condition where your pancreas doesn't make enough digestive enzymes used to break down food for your body to absorb.
Somatuline Autogel is not recommended for use in children.
Taking other medicines
Tell your doctor if you are taking any other medicines, including any that you buy without a prescription at your pharmacy, supermarket or health food shop.
Some medicines and Somatuline Autogel may interfere with each other. Somatuline Autogel may reduce the intestinal absorption of other drugs administered at the same time (e.g. cyclosporin A) or increase the bioavailability of bromocriptine. The dose of other drugs which reduce the heart rate (e.g. beta-blockers) may need to be reduced if Somatuline Autogel is administered.
Somatuline Autogel may interfere with the breakdown of some drugs by the liver enzymes (e.g. quinidine or terfenadine).
Your doctor or pharmacist have more information on medicines to be careful with or avoid while taking this medicine.
How will SOMATULINE AUTOGEL be given?
Somatuline Autogel is intended for deep injection under the skin. It is for single use only. It should be injected as described in the instructions in this leaflet.
For the treatment of acromegaly or the symptoms of carcinoid syndrome, the recommended starting dose is 60 mg to 120 mg injected every 28 days. Depending on your response to the product, your doctor may vary the dose or the injection frequency. Your doctor will also decide on the length of your treatment.
For the treatment of advanced tumours of the intestine and pancreas that cannot be removed by surgery (gastroenteropancreatic neuroendocrine tumours – GEP-NETs), the recommended dose is 120mg every 28 days. Your doctor will decide how long you should be treated with Somatuline Autogel for tumour control.
If you are controlled on Somatuline Autogel, your doctor may suggest that the injection can be given by yourself or your carer. Your doctor or nurse will give you or your carer the appropriate training and confirm that you are both motivated and capable of doing this. Your doctor will continue to supervise the long-term management of your condition.
If the injection is being administered by a healthcare professional or your carer, the injection will usually be given as a deep subcutaneous injection in the upper, outer external quadrant of the buttock.
If you are giving the injection to yourself, the deep subcutaneous injection should be given in the upper, outer thigh.
The injection site should be alternated between right and left sides.
What shall I do if I miss an injection?
As soon as you realise that you have missed an injection, contact your doctor who will then advise when your next injection is to be given.
Side Effects
The following side effects have been reported as common or very common in patients receiving Somatuline Autogel injections:
- bowel problems including diarrhoea or loose stools, abdominal pain, passing wind or constipation
- feeling sick, vomiting, heartburn, abdominal bloating or discomfort
- possible occurrence of gallbladder stones (cholelithiasis) with long-term treatment. You may have symptoms such as severe and sudden abdominal pain, high fever, jaundice (yellowing of the skin and whites of the eyes), chills, loss of appetite, itchy skin.
- changes in blood sugar levels (low and high), diabetes
- slowing of the heart rate
- tiredness
- headache, dizziness
- hair loss or no hair growth
- moderate and short-lived pain at the injection site, sometimes with redness, swelling (nodule), itching tenderness or abscess
- changes in some liver or pancreas test results
- weight loss
- lack of energy
- feeling generally weak
- decrease in appetite
- pain that affects muscles, ligaments, tendons and bones
- excess fat in the stools
- biliary dilatation (enlargement of the bile ducts between your liver and gall bladder and the intestine). You may have symptoms such as stomach pain, nausea, jaundice and fever.
If you are diabetic, your doctor may check your blood sugar levels and possibly alter your anti-diabetic treatment while you are receiving Somatuline Autogel.
If you have heart problems, your doctor may check your heart rate and possibly alter your treatment while you are taking Somatuline Autogel.
Due to the possibility of gallbladder problems with this type of medicine, your doctor may want to conduct a gallbladder scan when you start receiving Somatuline Autogel and again at regular intervals thereafter.
Tell your doctor immediately if you notice any of the following side effects:
- feeling more thirsty or tired than usual and having a dry mouth. These may be signs that you have high blood sugar levels or are developing diabetes.
- feeling hungry, shaky, sweating more than usual or feeling confused. These may be signs of low blood sugar levels.
The frequency of the following side effects cannot be estimated from the available data:
- sudden, severe abdominal pain that may spread to the shoulder or back, tenderness of the abdomen, feeling nauseous, vomiting and having a fever, or having dark urine, clay-coloured stools or yellowing of the skin and eyes (jaundice). These may be signs of gallstone complications.
Tell your doctor immediately if you notice that:
- your face becomes flushed or swollen or you develop spots or a rash
- your chest feels tight, you become short of breath or wheezy
- you feel faint, possibly as a result of a drop in blood pressure
These might be the result of an allergic reaction. The frequency of these side effects is not known; it cannot be estimated from the available data.
If any side effect is troublesome or causes any concern, you should tell your doctor or pharmacist.
What will happen if I am given too much? (Overdose)
As Somatuline Autogel is given to you under the supervision of your doctor, it is very unlikely that you will receive too much. Somatuline Autogel comes in a syringe pre-filled with the dose your doctor has prescribed. However, if you feel you have been given too much Somatuline Autogel, contact the Poisons Information Centre on 131126 for advice.
How to store SOMATULINE AUTOGEL
Store Somatuline Autogel at 2°C-8°C in a refrigerator in its original package. Do not freeze. Keep it out of the reach and sight of children.
The syringe can be temporarily stored outside of the refrigerator up to a maximum of 72 hours (make sure the temperature stays below 40°C). Return the syringe to the refrigerator as soon as possible for continued storage and use.
Talk to your doctor or pharmacist if you have any questions on the storage of Somatuline Autogel.
DO NOT USE AFTER THE EXPIRY DATE SHOWN ON THE LABELS AND BOX.
DO NOT USE IF THE LAMINATED POUCH IS DAMAGED OR OPENED.
Product Description
What it looks like
Each Somatuline Autogel pre-filled syringe is packed in a laminated pouch and a cardboard box.
Each box contains one 0.5 mL pre filled syringe with an automatic safety system with an attached needle (1.2 mm x 20 mm).
Ingredients
Somatuline Autogel 60 mg contains lanreotide acetate 60 mg as the active ingredient.
Somatuline Autogel 90 mg contains lanreotide acetate 90 mg as the active ingredient.
Somatuline Autogel 120 mg contains lanreotide acetate 120 mg as the active ingredient.
The other ingredients are sterile water and acetic acid.
Further information
If you have any further questions on your Somatuline Autogel treatment, or are unsure of the information, please see your doctor, who will be able to assist you.
Sponsor
Somatuline Autogel is sponsored in Australia by:
Ipsen Pty Ltd
Level 5
627 Chapel Street
South Yarra Victoria 3141
Australian Registration Number (AUST R):
Somatuline Autogel 60 mg: 95260
Somatuline Autogel 90 mg: 95261
Somatuline Autogel 120 mg: 95262
Date of preparation of this leaflet:
August 2023
Somatuline® and Autogel® are registered trademarks of Ipsen Pharma S.A.S.
Instructions for administration of the product
The following instructions explain how to inject Somatuline Autogel.
PLEASE READ ALL THE INSTRUCTIONS CAREFULLY BEFORE STARTING THE INJECTION.
The injection is a deep subcutaneous injection that requires a specific technique different to normal subcutaneous injections.
Somatuline Autogel is supplied in a ready to use pre-filled syringe fitted with an automatic safety system. The needle will retract automatically following the full administration of the product, to prevent needle stick injury.
- Ensure that the medication has been refrigerated in its original package.
Remove Somatuline Autogel from the refrigerator 30 minutes prior to administration. Injection of cold medication may be painful. Keep laminated pouch sealed until just prior to injection.
- Before opening the pouch, check that it is intact and that the medication has not expired. The expiration date is printed on the outer carton and the pouch.
DO NOT USE IF:
- YOU DROP OR DAMAGE THE PRE-FILLED SYRINGE
- THE PRE-FILLED SYRINGE OR POUCH APPEAR DAMAGED IN ANY WAY.
- THE PRODUCT HAS EXPIRED
If any of the above apply you should contact your doctor or pharmacist.
- Wash hands with soap and ensure there is a clean area for preparation.
- Tear open the pouch along the dotted line and take out the prefilled syringe. The content of the pre-filled syringe is semi-solid with a gel-like appearance, and a colour varying from white to pale yellow. The solution can also contain very small bubbles that can clear up during injection. These differences are normal and do not interfere with the quality of the product
After opening the protective laminated pouch, the product should be administered immediately.
- Select an injection site:
5a. If a healthcare professional (HCP) or someone else like a trained family member or friend is doing the injection: use the superior external (upper, outer) quadrant of the buttock for injection, or
5b. If you are injecting yourself: use the upper outer part of your thigh.
- Alternate the injection site between the right and left side each time you receive an injection of Somatuline Autogel. Avoid areas with moles, scar tissue, reddened skin, or skin that feels bumpy.
- Clean the injection site without rubbing the skin excessively and let it dry.
- Before injecting, remove the prefilled syringe from its tray. Discard the tray.
- Remove the needle cap by pulling it off and discard it.
- Flatten injection area using the thumb and index finger of the hand not holding the pre-filled syringe to stretch the skin. Do not pinch the skin. Use a strong, straight dart-like motion to quickly insert the needle perpendicular to the skin (90° angle), all the way into the skin.
It is very important that you insert the needle completely. You should not see any needle once it is fully inserted.
Do not aspirate (do not draw back)
- Release injection site that has been flattened by your hand. Push plunger with steady very firm pressure. The medication is thicker and harder to push than you might expect. Typically, 20 seconds are needed. Inject the full dose and give a final push to make sure you cannot depress it any further.
Note: maintain pressure on the plunger with your thumb to avoid activation of the automatic safety system.
- Without releasing the pressure on the plunger, withdraw the needle from the injection site.
- Then release pressure on the plunger. The needle will automatically retract into the needle guard where it will be locked permanently.
- Apply gentle pressure to the injection site with a dry cotton ball or sterile gauze to prevent any bleeding. DO NOT rub or massage the injection site after administration.
- Dispose of the used syringe in the syringe disposal container as instructed by your doctor or healthcare provider. DO NOT dispose of the device in your general household rubbish.
Keep the disposal container and Somatuline Autogel out of reach and sight of children.
Published by MIMS October 2023