SIGNIFOR LAR Rx
Generic Name and Formulations:
Pasireotide pamoate 20mg, 40mg, 60mg; pwd for IM inj after reconstitution.
Novartis Pharmaceuticals Corp
Indications for SIGNIFOR LAR:
Treatment of patients with acromegaly who have had an inadequate response to surgery and/or for whom surgery is not an option.
Give by IM inj into the right or left gluteus. Initially 40mg every 4 weeks (28 days); may increase dose to max 60mg after 3 months if GH and/or IGF-1 levels not normalized. If over-response to treatment, may decrease in 20mg decrements. Hepatic impairment: moderate (Child-Pugh B): initially 20mg every 4 weeks; max: 40mg every 4 weeks; severe (Child-Pugh C): avoid.
<18yrs: not established.
Monitor for adrenal insufficiency; give steroid replacement therapy if confirmed. Risk of hyperglycemia; initiate or adjust antidiabetic treatment if occurs; reduce dose or discontinue if remains uncontrolled. Monitor HbA1c and FPG prior to initiation, weekly for first 3 months, 4–6 weeks after dose increase, and thereafter as indicated. Congenital long QT prolongation. Cardiac disease (eg, recent MI, CHF, unstable angina, significant bradycardia); monitor QT interval at 21 days. High-grade heart block. Hypokalemia and/or hypomagnesemia; correct and monitor electrolytes prior to starting and during therapy. Monitor liver tests prior to initiation, 2–3 weeks after, then monthly for 3 months, then as indicated. Discontinue if significant hepatic impairment develops. Monitor baseline ECG, pituitary function prior to initiation and periodically during treatment. Renal impairment: not studied. Premenopausal women: potential for unintended pregnancy due to improved fertility. Pregnancy. Nursing mothers.
Cyclohexapeptide somatostatin analog.
Caution with antiarrhythmics or other drugs that may prolong the QT interval. May antagonize cyclosporine (adjust dose). May potentiate bromocriptine; dose reduction may be needed.
Diarrhea, hyperglycemia, diabetes, cholelithiasis (monitor); bradycardia, QT prolongation, pituitary hormone deficiency.
Single-use kit—1 (w. diluents, supplies)
Clinical Pain Advisor Articles
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Prescribed Opioids Difficulties Scale Effective for Assessing Concerns of Patients With Chronic Pain
- Predictors of Opioid Overdose in High-Risk Users
- Optimal Strategies for Opioid Weaning After Ambulatory Surgery
- Emergency Physicians Offer Recommendations for Identifying and Managing Opioid Use Disorder
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKR
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Erenumab Reduces Monthly Migraine Days in Patients With Treatment-Resistant Migraine
- Government and Industry Lead the Way in Funding USPSTF Systematic Reviews
- Communication-Based Intervention Increases Goals-of-Care Discussions Between Physicians, Patients With Serious Illness