What is Pasireotide: Uses, Dosage, Side Effects and More

Pasireotide is a synthetic hormone medication that mimics a natural hormone called somatostatin in your body. It's designed to help control hormone levels in people with certain rare endocrine conditions, particularly those affecting the pituitary gland and adrenal glands.

This medication works by binding to specific receptors in your body to reduce the production of excess hormones. Think of it as a regulatory switch that helps bring overactive hormone-producing cells back into balance when your body's natural control systems aren't working properly.

What is Pasireotide Used For?

Pasireotide is primarily prescribed for Cushing's disease, a rare condition where your pituitary gland produces too much of a hormone called ACTH. This leads to your adrenal glands making excessive amounts of cortisol, which can cause serious health problems throughout your body.

Your doctor might also prescribe pasireotide for acromegaly, another rare condition where your pituitary gland produces too much growth hormone. This typically happens in adults and can cause various physical changes and health complications if left untreated.

In some cases, healthcare providers use pasireotide to treat certain types of neuroendocrine tumors. These are rare tumors that can produce excess hormones and cause uncomfortable symptoms like flushing, diarrhea, or abdominal pain.

How Does Pasireotide Work?

Pasireotide is considered a potent medication that works by mimicking your body's natural hormone somatostatin. It attaches to specific receptors on hormone-producing cells, essentially telling them to slow down their activity.

When you have conditions like Cushing's disease or acromegaly, certain cells in your pituitary gland become overactive and produce too much hormone. Pasireotide acts like a brake pedal, helping to reduce this excessive hormone production and bring levels closer to normal.

The medication is particularly effective because it targets multiple types of somatostatin receptors. This broad approach helps it work on different types of hormone-producing cells, making it useful for various endocrine conditions.

How Should I Take Pasireotide?

Pasireotide comes in two forms: subcutaneous injections that you give yourself under the skin, and intramuscular injections that are given deep into muscle tissue by a healthcare provider. The form you'll use depends on your specific condition and your doctor's recommendation.

For subcutaneous injections, you'll typically inject the medication twice daily into areas like your thigh, abdomen, or upper arm. Your healthcare team will teach you the proper injection technique and help you rotate injection sites to prevent skin irritation.

If you're receiving intramuscular injections, these are usually given once monthly at your doctor's office or clinic. The medication is injected deep into your buttock muscle by a trained healthcare professional.

You can take pasireotide with or without food, but try to maintain consistency with your routine. Some people find it helpful to take it at the same times each day to maintain steady hormone levels in their body.

How Long Should I Take Pasireotide For?

The duration of pasireotide treatment varies significantly depending on your specific condition and how well you respond to the medication. For many people with Cushing's disease or acromegaly, this becomes a long-term treatment that may continue for years.

Your doctor will regularly monitor your hormone levels through blood tests to see how well the medication is working. These check-ups typically happen every few months initially, then may become less frequent once your levels stabilize.

Some people may need to take pasireotide indefinitely to keep their hormone levels controlled. Others might use it as a bridge treatment while preparing for surgery or other interventions. Your healthcare team will work with you to determine the best approach for your situation.

What Are the Side Effects of Pasireotide?

Like all medications, pasireotide can cause side effects, though not everyone experiences them. Understanding what to expect can help you feel more prepared and know when to contact your healthcare provider.

The most common side effects tend to be manageable and often improve as your body adjusts to the medication:

• High blood sugar levels (hyperglycemia) - this is the most frequent side effect
• Nausea and stomach discomfort
• Diarrhea or loose stools
• Injection site reactions like redness or swelling
• Headaches
• Fatigue or feeling more tired than usual
• Dizziness
• Abdominal pain

These common effects usually become less bothersome over time as your body adapts to the treatment.

Some people may experience more significant side effects that require closer monitoring:

• Diabetes or worsening of existing diabetes
• Gallbladder problems or gallstones
• Heart rhythm changes
• Liver function changes
• Low blood pressure
• Kidney function changes

Your doctor will monitor you regularly for these more serious effects through blood tests and other examinations.

Rare but serious side effects can include severe allergic reactions, significant heart rhythm problems, or severe liver issues. While these are uncommon, it's important to know the warning signs and seek immediate medical attention if they occur.

Who Should Not Take Pasireotide?

Pasireotide isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. People with certain heart conditions, particularly those with abnormal heart rhythms, may not be good candidates for this medication.

If you have severe liver disease, your doctor will likely avoid prescribing pasireotide or use it with extreme caution. The medication can affect liver function, so existing liver problems could become worse.

People with uncontrolled diabetes should have their blood sugar well-managed before starting pasireotide. Since the medication can raise blood sugar levels, starting with poorly controlled diabetes could lead to serious complications.

Pregnant women should not take pasireotide unless the benefits clearly outweigh the risks. If you're planning to become pregnant or are breastfeeding, discuss this thoroughly with your healthcare provider.

Pasireotide Brand Names

Pasireotide is available under the brand name Signifor for both subcutaneous and intramuscular formulations. The subcutaneous version is often called Signifor, while the long-acting intramuscular version is known as Signifor LAR.

Both formulations contain the same active ingredient but are designed for different dosing schedules. Your doctor will choose the most appropriate form based on your specific needs and lifestyle considerations.

Pasireotide Alternatives

If pasireotide isn't suitable for you or doesn't provide adequate control of your condition, several alternatives might be considered. Octreotide is another somatostatin analog that works similarly but may have different side effect profiles.

For Cushing's disease specifically, medications like ketoconazole, metyrapone, or mifepristone might be options. These work through different mechanisms to control cortisol levels.

Surgical options, such as pituitary surgery for Cushing's disease or acromegaly, might be considered either as alternatives to medication or in combination with drug therapy. Your endocrinologist will help determine the best approach for your specific situation.

Is Pasireotide Better Than Octreotide?

Pasireotide and octreotide are both somatostatin analogs, but they work slightly differently in your body. Pasireotide binds to more types of somatostatin receptors, which can make it more effective for certain conditions.

For Cushing's disease, pasireotide is often preferred because it has better activity at the specific receptors found in pituitary tumors that cause this condition. Octreotide typically isn't as effective for Cushing's disease.

However, for acromegaly and neuroendocrine tumors, both medications can be effective. The choice often depends on factors like side effect tolerance, dosing convenience, and individual response to treatment.

Your doctor will consider your specific condition, medical history, and treatment goals when choosing between these medications. Sometimes, people who don't respond well to one medication may do better with the other.