Starting Somatuline Depot (lanreotide)Your first 90 days with acromegaly: the steps, the dates and who to call

How you take it

One shot every 4 weeks, given by a nurse or doctor at the office, deep under the skin of the upper buttock. The usual first dose is 90mg, and blood tests after 3 months decide the dose after that.

Before your first dose

• Your doctor's office starts your sign-up with IPSEN CARES, the drugmaker's support program, and you sign a form that lets them see your health information.
• IPSEN CARES checks what your insurance covers and what you will owe, usually within 1 business day.
• Your insurance approves the medicine. Plans such as Cigna want an IGF-1 blood test from before treatment and the reason surgery or radiation was not enough.
• A specialty pharmacy sends the shot to your doctor's office, or the office buys it and bills your plan.
• Tell your doctor about diabetes and any heart, thyroid, gallbladder, kidney or liver problems, because your blood sugar is checked when you start.

The first 90 days

1. 3 weeks beforeEnrollment form signed and sent
2. About 1 business dayBenefits check
3. About 2 weeks beforeInsurance approval
4. Week beforeThe syringe is shipped
5. Day 1Dose 1, usually 90mg
6. OngoingBlood sugar checks
7. Days afterThe injection site
8. 4 weeks after dose 1, then every 28 daysSecond shot, 4 weeks after the first, then every 4 weeks
9. Week before dose 4Blood tests for growth hormone and IGF-1 before your fourth shot
10. Month 3 visitFourth shot, which may be a new dose