Formulary
Pasireotide: Indications, Dosing, Side Effects and Interactions
Pasireotide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Pasireotide: Indications, Dosing, Side Effects and Interactions
Pasireotide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Cushing's disease [when surgery has failed or is inappropriate]**
- **Adult** (By Subcutaneous Injection): Initially 600 micrograms twice daily for 2 months, then increased if necessary to 900 micrograms twice daily, consider discontinuation if no response after 2 months of treatment, for dose adjustment due to side-effects-consult product literature.
- **Adult** (By Deep Intramuscular Injection): Initially 10 mg every 4 weeks, increased if necessary up to 40 mg every 4 weeks, dose may be titrated every 2-4 months based on response and tolerability, consider discontinuation if no clinical benefit observed, for dose adjustment due to side-effects-consult product literature.
**Acromegaly [when surgery has failed or is inappropriate, and control with another somatostatin analogue is inadequate]**
- **Adult** (By Deep Intramuscular Injection): Initially 40 mg every 4 weeks, increased if necessary up to 60 mg every 4 weeks, dose may be increased if levels of growth hormone and/or insulin-like growth factor-1 are not fully controlled after 3 months of initial dosing, for dose adjustment due to side-effects-consult product literature.
Cautions
For all somatostatin analogues Diabetes mellitus (antidiabetic requirements may be altered); growth hormone-secreting pituitary tumours can expand during treatment (causing serious complications); insulinoma (increased depth and duration of hypoglycaemia may occur-observe patients and monitor blood glucose levels when initiating treatment and changing doses) Cautions For pasireotide Cardiac disorders (including bradycardia); susceptibility to QT-interval prolongation (including electrolyte disturbances)
Side effects
For all somatostatin analogues Common or very common Alopecia; appetite decreased; asthenia; cholecystitis; cholelithiasis (following long term use); cholestasis; constipation; diabetes mellitus; diarrhoea; dizziness; gastrointestinal discomfort; gastrointestinal disorders; glucose tolerance impaired (following long term use); headache; hyperglycaemia (long term use); hypoglycaemia; myalgia; nausea; pruritus; sinus bradycardia; vomiting Side-effects For pasireotide Common or very common Adrenal insufficiency; arthralgia; hypotension; QT interval prolongation Uncommon Anaemia
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate impairment (risk of increased exposure); avoid in severe impairment. Dose adjustments With subcutaneous use for Cushing's disease: Manufacturer advises reduce initial dose to 300 micrograms twice daily (max. dose 600 micrograms twice daily) in moderate impairment. With intramuscular use for Cushing's disease: Manufacturer advises max. dose 20 mg every four weeks in moderate impairment. When used for Acromegaly: Manufacturer advises reduce initial dose to 20 mg every four weeks (max. dose 40 mg every four weeks) in moderate impairment.
Renal impairment
Manufacturer advises caution in severe impairment-increased plasma-pasireotide exposure.
Medicinal forms
Solution,Injection
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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