pasireotide diaspartate: clinical use

Prescribing considerations

• Treatment should be initiated and supervised by clinicians experienced in managing Cushing’s disease.
• Assess glycaemic control, cardiovascular risk, QT-prolongation risk, bradycardia, interacting medicines and electrolyte abnormalities.
• Use caution in severe renal impairment or end-stage renal disease.
• Discuss possible improved fertility and contraception where relevant.

Contraindications and cautions

• Hypersensitivity to pasireotide or an excipient
• Severe hepatic impairment

Monitoring

• Fasting plasma glucose, HbA1c and clinically appropriate home glucose measurements
• Liver function
• ECG, heart rate, potassium and magnesium according to cardiac risk
• Clinical and biochemical evidence of low cortisol
• Gallbladder ultrasound before treatment and periodically thereafter
• Pituitary function where clinically appropriate
• Clinical response using cortisol measures and features of hypercortisolism

Clinical pharmacology

Pasireotide is a cyclohexapeptide somatostatin analogue with high affinity for several somatostatin receptors, particularly subtype 5. The subcutaneous formulation is rapidly absorbed and is cleared mainly through the hepatobiliary route.

Formulation and product differences

• This page covers a clear, colourless solution for subcutaneous injection in a glass ampoule.
• Pasireotide pamoate is a different intramuscular depot formulation and is not directly interchangeable.
• The ampoule is for single use and the solution must not be mixed with other medicinal products.

Injection

Route: Parenteral

Strengths: 0.3 mg, 0.6 mg, 0.9 mg