Pasireotide Dosage

Medically reviewed by Drugs.com. Last updated on Feb 28, 2025.

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

CONTRAINDICATIONS: None

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

Consult WARNINGS section for dosing related precautions.

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.

See also:

Further information

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

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