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Pasireotide Dosage

Medically reviewed on August 14, 2018.

Applies to the following strengths: 0.3 mg/mL; 0.6 mg/mL; 0.9 mg/mL; 20 mg; 40 mg; 60 mg; 30 mg; 10 mg

Usual Adult Dose for Cushing's Syndrome

Intramuscular formulation:
Initial dose: 10 mg intramuscularly every 4 weeks (28 days)
Maximum dose: 40 mg intramuscularly every 4 weeks (28 days), after 4 months of treatment with 10 mg for patients without normalized 24-hour urinary free cortisol (UFC) levels after 4 months treatment who tolerated the 10 mg dose


Subcutaneous formulation:
Initial dose: 0.6 mg or 0.9 mg subcutaneously twice daily.
Maintenance dose: 0.3 to 0.9 mg subcutaneously twice daily.
Maximum dose: 0.9 mg subcutaneously twice daily
Duration of therapy: Treatment should be continued as long as benefit is derived.

Comments:
-Titrate dose based on response and tolerability.
-Perform baseline evaluations of fasting plasma glucose, hemoglobin A1c, liver tests, electrocardiogram, serum potassium, and serum magnesium prior to initiating therapy.
-Optimize glucose control in poorly controlled diabetics prior to initiating therapy.

Use: The treatment of adult patients with Cushing's disease for whom pituitary surgery is not an option or has not been curative.

Usual Adult Dose for Acromegaly

Intramuscular formulation:
Initial dose: 40 mg, IM, every 28 days
Maximum dose: 60 mg, IM, every 28 days for patients without normalized growth hormone (GH) and/or age and sex adjusted insulin-like growth factor (IGF-1) levels after 3 months treatment who tolerated the 40 mg dose

Comments:
-Titrate dose based on response and tolerability.
-Evaluate fasting plasma glucose, HbA1c, liver enzymes, electrocardiogram, and serum magnesium and potassium prior to therapy.
-Optimize glucose control in poorly controlled diabetes prior to therapy.

Use: Treatment of patients with acromegaly with an inadequate response to surgery and/or for whom surgery is not an option.

Renal Dose Adjustments

No dosage adjustment is required in patients with impaired renal function.

Liver Dose Adjustments

Cushing's:
Mild liver dysfunction (Child-Pugh A): No adjustment recommended
Moderate liver dysfunction (Child-Pugh B): Initial dose is 0.3 mg twice daily. Maximum dose is 0.6 mg twice daily.
Severe liver dysfunction (Child-Pugh C): Avoid use

Acromegaly:
Mild liver dysfunction (Child-Pugh A): No adjustment recommended
Moderate Hepatic Impairment (Child Pugh B): Initial dose: 20 mg IM every 28 days; maximum dose: 40 mg every 28 days
Severe Hepatic Impairment (Child Pugh C): Avoid use

Dose Adjustments

Cushing's:

Subcutaneous formulation:
Mild liver dysfunction (Child-Pugh A): No adjustment recommended.
Moderate liver dysfunction (Child-Pugh B): Initial dose is 0.3 mg twice daily. Maximum dose is 0.6 mg twice daily.
Severe liver dysfunction (Child-Pugh C): Avoid use

Intramuscular formulation:
Mild liver dysfunction (Child-Pugh A): No adjustment recommended.
Moderate liver dysfunction (Child-Pugh B): Initial dose is 10 mg once every 4 weeks. Maximum dose is 20 mg once every 4 weeks.
Severe liver dysfunction (Child-Pugh C): Avoid use


Acromegaly:
Intramuscular formulation:
Mild liver dysfunction (Child-Pugh A): No adjustment recommended.
Moderate liver dysfunction (Child-Pugh B): Initial dose is 20 mg once every 4 weeks. Maximum dose is 40 mg once every 4 weeks.
Severe liver dysfunction (Child-Pugh C): Avoid use

Precautions

Consult WARNINGS section for dosing related precautions.

Safety and efficacy have not been established in patients younger than 18 years.

Dialysis

Data not available

Other Comments

Administration advice:
-Refer to the manufacturers product information for detailed administration instructions.

Reconstitution/preparation techniques:
-Refer to the manufacturers product information for detailed preparation instructions.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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