Pasireotide
Aliases: Signifor
Last verified: 2026-09-23
The short version
A broader-spectrum somatostatin analogue (SSTR1/2/3/5) — approved for Cushing's disease and first-line-resistant acromegaly.
Identity & type
- Molecular type
- analog
- Origin
- A broader-spectrum somatostatin analogue (SSTR1/2/3/5) — approved for Cushing's disease and first-line-resistant acromegaly.
Mechanism of action
Broader SSTR profile → suppression of tumor ACTH/GH secretion.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. SC 0.3–0.9 mg twice daily; LAR 10–40 mg monthly.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
SC 0.3–0.9 mg twice daily; LAR 10–40 mg monthly. Signifor: a broader somatostatin profile — lowers cortisol in Cushing's disease, but often raises glucose.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Signifor: a broader somatostatin profile — lowers cortisol in Cushing's disease, but often raises glucose.
Protocol — official vs community
Official / label
Signifor (Cushing's disease): 0.3–0.9 mg SC twice daily, titrated by urinary free cortisol. Signifor LAR (acromegaly after surgery or first-line somatostatin-analog failure): 10–40 mg IM every 4 weeks.
- 01Cushing's: start 0.6 mg SC BID; adjust in 0.3 mg steps by 24-h urinary free cortisol
- 02LAR acromegaly: start 40 mg q4wk; reduce to 10–20 mg if over-suppressed or intolerant
Duration: Chronic while biochemical control is needed; Cushing's response should be assessed within ~2 months before committing.
Its broader SSTR profile buys ACTH suppression that octreotide cannot deliver, at the price of markedly worse hyperglycemia — glucose monitoring is part of the protocol, not an afterthought.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
Approved 2012/2014; unique for ACTH suppression.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Hyperglycemia (common, significant), gallstones.characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials