# Pasireotide

> Pasireotide is a multi-receptor somatostatin analog approved for Cushing's disease and acromegaly, with a broader somatostatin receptor binding profile (SSTR1, 2, 3, and 5) than octreotide or lanreotide. Its stronger SSTR5 affinity makes it particularly relevant for suppressing ACTH secretion in Cushing's disease driven by pituitary corticotroph tumors. It is used both as first-line therapy in select patients and as an option after surgery or other somatostatin analogs have failed.

- URL: https://www.lifeconverted.com/peptides/pasireotide
- Also known as: Signifor
- Primary category: Other & Clinical
- Effectiveness rank: #13 in Other & Clinical
- Evidence level: Well studied
- Route: Subcutaneous (Immediate-release pasireotide is given subcutaneously twice daily; a long-acting intramuscular depot formulation also exists.)
- Dose range: 300-900 mcg
- Dose tiers: low 300 mcg; moderate 600 mcg; high 900 mcg
- Half-life: Approximately 12 hours for the immediate-release subcutaneous formulation
- Timing: Twice daily (AM & PM)
- Cycle: Continuous twice-daily dosing or monthly depot, typically long-term per condition on, Discontinued per prescriber decision off
- Storage: Refrigerate ampoules at 2-8°C; may be stored at room temperature short-term per the label. Protect from light.

## Mechanism of action

Pasireotide binds multiple somatostatin receptor subtypes, especially SSTR5, suppressing ACTH release from pituitary corticotroph tumors in Cushing's disease and reducing GH/IGF-1 secretion in acromegaly, via Gi-coupled inhibition of hormone release.

## Reported benefits

- Reduces cortisol excess in Cushing's disease
- Normalizes GH and IGF-1 in acromegaly
- Option for patients unresponsive to other somatostatin analogs
- Available in both immediate-release and long-acting depot forms

## Reported side effects

- Hyperglycemia or new-onset diabetes, more pronounced than with other somatostatin analogs
- Gastrointestinal upset
- Gallstones
- Injection site reactions
- QT interval prolongation risk

## Common protocols

- Cortisol control in Cushing's disease
- Acromegaly management, including after failure of other somatostatin analogs

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