Select therapeutic use:
Indications for SIGNIFOR:
Treatment of adult patients with Cushing’s disease for whom pituitary surgery is not an option or has not been curative.
Initially 0.6mg or 0.9mg by SC inj twice daily into thigh or abdomen; usual range: 0.3mg–0.9mg twice daily. Titrate based on response and tolerability. Hepatic impairment: moderate (Child-Pugh B): initially 0.3mg twice daily; max 0.6mg twice daily; severe (Child-Pugh C): avoid.
<18yrs: not established.
Monitor for hypocortisolism; consider temporary dose reduction, interruption or steroid replacement therapy if occurs. Risk of hyperglycemia; initiate or adjust antidiabetic treatment if occurs; reduce dose or discontinue if remains uncontrolled. Monitor HbA1c or FPG prior to initiation, every week for the first 2–3 months, for 2–4 weeks after dose increase, and thereafter as indicated. Congenital long QT prolongation. Cardiac disease (including recent MI, CHF, unstable angina, significant bradycardia). High-grade heart block. Hypokalemia and/or hypomagnesemia; correct and monitor electrolytes prior to starting and during therapy. Monitor liver tests 1–2 weeks after initiation, monthly for 3 months, then every 6 months thereafter; measure liver enzymes weekly or more frequently as indicated. Transsphenoidal surgery. Pituitary irradiation. Monitor baseline ECG, gallbladder ultrasound, pituitary function prior to initiation and periodically during treatment. Pregnancy (Cat.C). Nursing mothers: not recommended.
Caution with antiarrhythmics or other drugs that may prolong the QT interval. May antagonize cyclosporine (adjust dose). May potentiate bromocriptine; dose reduction may be needed.
Cyclohexapeptide somatostatin analog.
Diarrhea, nausea, hyperglycemia, diabetes, cholelithiasis, headache, abdominal pain, fatigue; bradycardia, QT prolongation, pituitary hormone deficiency.