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Pasireotide

Somatostatin Analog (pan-receptor)

Also known as: Signifor · Signifor LAR

A multireceptor-targeted somatostatin analog with broader SSTR binding than octreotide. FDA approved for Cushing's disease & acromegaly refractory to first-line treatment.

Typical Dose

0.3–0.9 mg 2–3x daily (Cushing's, short-acting); 40–60 mg monthly (LAR, acromegaly)

Route

Subcutaneous (short-acting) or IM LAR (acromegaly)

Cycle

Ongoing, defined by indication

Half-life

~12 hours (short-acting); controlled release (LAR)

Storage

Room temperature.

Overview

Pasireotide differs from octreotide & lanreotide by binding somatostatin receptors 1, 2, 3, & 5 (pan-SSTR), compared to the SSTR2/5 selectivity of earlier analogs. This broader receptor binding is the basis for its efficacy in Cushing's disease (driven largely by SSTR5 on corticotroph tumors) & in acromegaly refractory to SSTR2-selective agents.

Quick Start Guide

1

Physician-administered. Complex dosing & monitoring — endocrinologist required.

Research Indications

Cushing's disease

Most Effective

FDA approved. Reduces UFC (urinary free cortisol) in Cushing's disease not controlled by first-line treatment.

Acromegaly (refractory)

Most Effective

FDA approved for acromegaly inadequately controlled by other somatostatin analogs.

Side Effects & Safety

Common

  • Hyperglycemia (more pronounced than with other SSAs)
  • GI effects
  • Cholelithiasis
  • Bradycardia

Uncommon

  • Hypocortisolism (in Cushing's disease)

When to Stop

  • Uncontrolled hyperglycemia
  • Signs of allergic reaction

How to Reconstitute

1

Commercial product. Physician-administered.

Dosing math: Clinical product.

Quality Indicators

Good — use as normal

  • Per manufacturer

Discard immediately

  • Per manufacturer

What to Expect

Month 1–3

Cortisol reduction begins. Glucose monitoring critical from day 1.

Community Insights

Self-reported. Reflects user experience, not clinical outcomes.

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