Somatuline Dosage/Direction for Use

Initiation of treatment: Acromegaly: The recommended starting dose is 60 mg to 120 mg administered every 28 days.
For example: in patients previously treated with SOMATULINE P.R. 30 mg powder and solvent for prolonged-release suspension for injection (I.M.) every 7 days, the initial dose of Somatuline Autogel should be 120 mg every 28 days.
Carcinoid tumours: The recommended starting dose is 60 mg to 120 mg administered every 28 days.
The dose should be adjusted according to the degree of symptomatic relief obtained.
Gastroenteropancreatic Neuroendocrine Tumours: The recommended dose is one injection of Somatuline Autogel 120 mg administered every 28 days. The treatment with Somatuline Autogel 120 mg should be continued for as long as needed for tumour control.
Adaptation of treatment: The treatment should be adjusted for each patient in a specialised unit.
The dose should be individualised according to the response which is evaluated by monitoring plasma GH and IGF-1 levels and by assessing changes in symptoms.
Acromegaly: It is recommended: to reduce the dose when the concentrations are normalised (GH < 1 ng/ml and normalised IGF-1 and/or disappearance of clinical symptoms), to maintain the dose when the concentrations of GH are between 2.5 ng/ml and 1 ng/ml, to increase the dose when the concentrations of GH are higher than 2.5 ng/ml.
Patients well controlled on a somatostatin analogue can be treated with Somatuline Autogel 120 mg every 42 or 56 days.
Long term monitoring of symptoms, GH and IGF-1 levels should be routinely carried out in all patients.
Carcinoid tumours: In case of an insufficient response judged by clinical symptom (reduction in episodes of flushing or diarrhoea), the dose may be increased to 120 mg every 28 days (4 weeks). In case of a sufficient response judged by clinical symptom (reduction in episodes of flushing or diarrhoea), the dose may be decreased to 60 mg every 28 days (4 weeks).
Renal and/or hepatic impairment: In patients with impaired renal or hepatic function, no dosage adjustment is necessary.
Elderly patients: In elderly patients, no dosage adjustment is necessary.
Paediatric population: Somatuline Autogel is not recommended for use in children and adolescents due to a lack of data on safety and efficacy.
Method of Administration: Somatuline Autogel is administered by deep subcutaneous injection in the superior external quadrant of the buttock or in the upper outer thigh. The injection is made by healthcare professional. However, for patients who receive a stable dose of Somatuline Autogel, the product may be administered either by the patient or by a person around him after appropriate training by a healthcare professional.
In case of self-injection, the injection should be made in the upper outer thigh.
The decision of administration by the patient or another trained person should be taken by the healthcare professional.
Regardless of the site of injection, the skin should not be folded and the needle should be inserted rapidly to its full length, perpendicularly to the skin.
The injection site should alternate between the right and left side.