Signifor (pasireotide)
Also marketed as Signifor LAR. An approved treatment for Acromegaly.
The same compound appears under different names depending on the context. Here is how to identify Pasireotide wherever you encounter it, plus the key facts at a glance.
- Generic name
- Pasireotide
- Brand names
- Signifor, Signifor LAR
- Development code
- SOM230
- Drug class
- Somatostatin analog (second-generation)
- Manufacturer
- Recordati Rare Diseases
- How it's taken
- Signifor LAR is given as an intramuscular injection every 4 weeks at a doctor's office.
A newer somatostatin analog that targets multiple receptor types, an option for some patients whose acromegaly is not controlled on first-generation drugs like octreotide or lanreotide.
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Where Pasireotide fits
Approved for acromegaly when surgery has not worked well enough or is not an option; the label does not require trying octreotide or lanreotide first, though it is often used as a second-line drug when those have not controlled the disease. Its safety and effectiveness in children have not been established. Binds to more somatostatin receptor subtypes but carries higher metabolic side effect risk.
How Pasireotide works
Pasireotide is a 'multireceptor' somatostatin analogue that binds to more types of somatostatin receptors than older drugs like octreotide or lanreotide. It has extra-strong binding to one particular receptor (SSTR5), making it effective for patients whose growth hormone doesn't respond well to first-generation drugs.
Mechanism: Multi-receptor somatostatin analog with preferential affinity for SSTR5, also binding SSTR1, SSTR2, and SSTR3
Side effects and safety
A major side effect is increased blood sugar and diabetes, new or worsened, in 26% of patients compared to 4% on the comparison drug in the main trial, and the share of patients with diabetes rose from 30% to 60% over 12 months. Other effects include diarrhea, nausea, and gallstones. Pasireotide can slow the heart rate and cause a heart rhythm change called QT prolongation, so an ECG and blood electrolytes are checked before starting and regularly during treatment. It can also raise liver enzymes, so liver tests are done before and during treatment. The label also warns that high blood sugar can be severe, sometimes with a dangerous acid buildup called ketoacidosis, that other pituitary hormones can drop, and about loose or fatty stools from poor fat absorption. Monitor blood sugar closely and tell your doctor about increased thirst or frequent urination.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Pasireotide
Signifor LAR is given as an intramuscular injection every 4 weeks at a doctor's office. Your blood sugar will be monitored regularly because of the diabetes risk, and you may need diabetes medicine while on this drug.
Availability and cost
Only available as the brand-name product.
Multi-receptor somatostatin analog with broader receptor binding than octreotide or lanreotide. Specialty pricing for patients who have not responded adequately to first-generation somatostatin analogs.
Help paying for Signifor
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Copay help
Recordati Rare Diseases offers a $20 co-pay for qualified patients with commercial insurance. Eligibility requirements apply.
For: private insurance · source - Other support
Financial assistance is offered for uninsured patients and patients with high out-of-pocket costs through the R.A.R.E. program.
For: no insurance, underinsured · source - Insurance and case manager help
R.A.R.E. helps with insurance verification, prior authorization, specialty pharmacy delivery, pharmacist and nurse follow-up, and refills.
The official page does not say who qualifies. Ask the program. · source - Other support
Patients starting SIGNIFOR LAR may be able to join a home injection program at no additional cost. Eligibility requirements apply.
The official page does not say who qualifies. Ask the program. · source
Good to know: SIGNIFOR and SIGNIFOR LAR are now marketed in the US by Recordati Rare Diseases, not Novartis. For acromegaly, SIGNIFOR LAR is the relevant product. Phone line: 1-888-855-RARE (7273).
- From a charity · TotalAssist (formerly PAN Foundation)Acromegaly fundOpen
Pays for: Out-of-pocket costs for approved medications, up to $5,000 per year. Requires Medicare, Medicaid or TRICARE.
- From a charity · The Assistance FundAcromegaly fundWaitlist
Pays for: Copays, coinsurance, deductibles and other health-related expenses.
The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
How acromegaly treatments compare
Five FDA-approved medications are available for acromegaly. Your endocrinologist will recommend a treatment based on your tumor size, IGF-1 levels, symptoms, and how you respond to initial therapy. This chart summarizes the key practical differences between options.
5 FDA-approved acromegaly treatments are available: Sandostatin LAR (octreotide, approved 1998); Somatuline Depot (lanreotide, approved 2007); Signifor LAR (pasireotide, approved 2014); Somavert (pegvisomant, approved 2003); Palsonify (paltusotine, approved 2025). Sandostatin LAR is typically used as first-line medical therapy (injectable).
| Drug | How it works | How it’s given | How often | Where you get it | Typical use | FDA approved |
|---|---|---|---|---|---|---|
Sandostatin LAR octreotide | Somatostatin analog — mimics a hormone that tells the pituitary to release less growth hormone | Intramuscular injection (gluteal muscle) | Every 4 weeks | Clinic or infusion center | First-line medical therapy (injectable) | 1998 |
Somatuline Depot lanreotide | Somatostatin analog — same receptor target as octreotide, but given as a deep subcutaneous gel rather than an intramuscular injection | Deep subcutaneous injection (upper outer buttock) | Every 4 weeks (FDA-approved extended dosing: 120mg every 6–8 weeks for biochemically controlled patients) | Clinic (healthcare provider administration per FDA label) | First-line medical therapy (injectable) | 2007 |
Signifor LAR pasireotide You are here | Multi-receptor somatostatin analog — targets more receptor subtypes than first-generation options | Intramuscular injection (gluteal muscle) | Every 4 weeks | Clinic or infusion center | Second-line, after first-generation somatostatin analogs | 2014 |
Somavert pegvisomant | Growth hormone receptor antagonist — blocks GH from binding to cells instead of reducing GH release | Subcutaneous injection (self-administered) | Daily | Home (self-injection) | Second-line or add-on to somatostatin analog | 2003 |
Palsonify paltusotine | Oral somatostatin agonist — activates the same SST2 receptor as injectable somatostatin analogs, taken as a pill | Oral tablet | Once daily | Home (oral, no injection needed) | First-line medical therapy, or switch from injectable somatostatin analog | 2025 |
This chart summarizes approved acromegaly treatments to help you understand the landscape. It is not medical advice. Treatment decisions depend on your individual health profile, tumor characteristics, lab results, and response to therapy. Dosing intervals shown reflect FDA labeling; your endocrinologist may adjust intervals based on your individual response. Always discuss options with your endocrinologist.
Clinical trial results
FDA approved Signifor LAR in December 2014 based on Phase 3 trials in which more patients reached combined growth hormone and IGF-1 control than on octreotide LAR (31% vs 19%). In people new to drug treatment, 39% on Signifor LAR reached a normal IGF-1 at 12 months (24% on the comparison drug). In people not controlled on first-generation drugs, about 25% reached a normal IGF-1 at 6 months, against 0% who stayed on their previous drug.
Development history
Novartis developed pasireotide as a next-generation somatostatin analogue with stronger binding to multiple receptors. Approved in December 2014 for patients with inadequate response to surgery or when surgery isn't an option.
Explore Acromegaly trials
Other Acromegaly treatments
Common questions about Pasireotide
▸What is Pasireotide (Signifor)?
A newer somatostatin analog that targets multiple receptor types, an option for some patients whose acromegaly is not controlled on first-generation drugs like octreotide or lanreotide.
▸How does Pasireotide work?
Pasireotide is a 'multireceptor' somatostatin analogue that binds to more types of somatostatin receptors than older drugs like octreotide or lanreotide. It has extra-strong binding to one particular receptor (SSTR5), making it effective for patients whose growth hormone doesn't respond well to first-generation drugs.
▸What are the side effects of Pasireotide?
A major side effect is increased blood sugar and diabetes, new or worsened, in 26% of patients compared to 4% on the comparison drug in the main trial, and the share of patients with diabetes rose from 30% to 60% over 12 months. Other effects include diarrhea, nausea, and gallstones. Pasireotide can slow the heart rate and cause a heart rhythm change called QT prolongation, so an ECG and blood electrolytes are checked before starting and regularly during treatment. It can also raise liver enzymes, so liver tests are done before and during treatment. The label also warns that high blood sugar can be severe, sometimes with a dangerous acid buildup called ketoacidosis, that other pituitary hormones can drop, and about loose or fatty stools from poor fat absorption. Monitor blood sugar closely and tell your doctor about increased thirst or frequent urination.
▸How is Pasireotide taken?
Signifor LAR is given as an intramuscular injection every 4 weeks at a doctor's office. Your blood sugar will be monitored regularly because of the diabetes risk, and you may need diabetes medicine while on this drug.
▸Is Pasireotide FDA approved?
Yes, Pasireotide (Signifor) is FDA approved (2014) for the treatment of Acromegaly.
▸How does pasireotide differ from octreotide and lanreotide?
Pasireotide is a second-generation somatostatin analog with preferential affinity for SSTR5 and broader receptor binding across SSTR1, 2, 3, and 5. In the label's trial of people not controlled on octreotide or lanreotide, 25% on 40 mg and 26% on 60 mg reached a normal IGF-1 at 6 months, against 0% who stayed on their previous drug.
▸What is the main side effect concern with pasireotide?
Hyperglycemia (high blood sugar) is a significant concern, occurring more frequently than with other somatostatin analogs due to pasireotide's effects on insulin secretion. Blood glucose monitoring is essential, and some patients may need diabetes medications.
▸Is pasireotide available as a long-acting injection?
Yes. Signifor LAR is the long-acting formulation given as a monthly intramuscular injection for acromegaly. The original Signifor (subcutaneous) was first used for Cushing disease.
▸When is pasireotide typically used for acromegaly?
Pasireotide is typically used as a second-line treatment for acromegaly when patients have not responded adequately to first-generation somatostatin analogs like octreotide or lanreotide. It was approved for acromegaly in 2014.
▸Is pasireotide also used for Cushing disease?
Yes. Pasireotide has a separate indication for Cushing disease, where it targets ACTH-secreting pituitary tumor cells. The Cushing indication was actually approved first, in 2012.
▸What patient support is available?
Signifor and Signifor LAR are now sold in the US by Recordati Rare Diseases. Its R.A.R.E. Patient Support Program (1-888-855-7273) helps with insurance, offers a $20 copay for eligible commercially insured patients, and has financial help for uninsured patients.