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Dosing and Administration

Titrate your patients to the dose they need to normalize IGF-I levels

Starting, monitoring, and titrating

  1. Establish baseline for IGF-I and liver testing
    • IGF-I levels are the biomarker of efficacy with SOMAVERT1
    • Baseline serum liver tests should be obtained prior to initiating therapy with SOMAVERT1
  2. Initiate SOMAVERT therapy
    • 40-mg loading dose in office, under physician supervision1
    • 10-mg daily self-administered at-home injections begin the following day1*
  3. Monitor IGF-I levels
    • Every 4-6 weeks until IGF-I is maintained within age-adjusted normal range1
    • Every 6 months once normalized
  4. Titrate if IGF-I is not normalized
    • In 5-mg increments or decrements every 4-6 weeks1
    • The maximum indicated daily maintenance dose for
      SOMAVERT is 30 mg1

While the goals of therapy are to achieve (and then maintain) IGF-I concentrations within the age-adjusted normal range and to alleviate the signs and symptoms of acromegaly, titration of dosing should be based on
IGF-I levels. It is unknown whether patients who remain symptomatic while achieving normalized IGF-I levels
would benefit from increased dosing with SOMAVERT.

Subcutaneous injection with a 1-cc insulin syringe

  • Patients maintain independence, scheduling flexibility, and privacy via at-home self-injection

*Patients and other persons who may administer SOMAVERT should be carefully instructed by a healthcare professional on how to properly reconstitute and inject the product.1

SOMAVERT® (pegvisomant for injection) is indicated for the treatment of acromegaly in patients who have had an inadequate response to surgery or radiation therapy, or for whom these therapies are not appropriate. The goal of treatment is to normalize serum insulin-like growth factor-I (IGF-I) levels.

IMPORTANT SAFETY INFORMATION FOR SOMAVERT

SOMAVERT is contraindicated in patients with a history of hypersensitivity to any of its components.

Patients on opioids often needed higher serum pegvisomant concentrations to achieve appropriate IGF-I suppression compared with patients not receiving opioids.

Patients with acromegaly and diabetes mellitus being treated with insulin and/or oral hypoglycemic agents may require dose reductions of these therapeutic agents after the initiation of treatment with SOMAVERT.

Important safety information regarding liver test monitoring
Baseline serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), and alkaline phosphatase (ALP) levels should be obtained prior to initiating therapy with SOMAVERT. Monitor liver tests based on baseline values and changes during therapy according to the schedule in the full Prescribing Information.

Asymptomatic, transient elevations in transaminases up to 15 times ULN have been observed in <2% of subjects among two open-label trials (with a total of 147 patients). These reports were not associated with an increase in bilirubin. Transaminase elevations normalized with time, most often after suspending treatment. If a patient develops liver test elevations, or any other symptoms of liver dysfunction while receiving SOMAVERT, please see Liver Tests section of the full Prescribing Information.

In subjects with systemic hypersensitivity reactions, caution and close monitoring should be exercised when re-initiating SOMAVERT therapy.

The most common adverse events (>6% and at frequencies greater than placebo) in 1 of the 3 active treatment arms in a placebo-controlled study (N=112) included infection (23%), pain (14%), nausea (14%), diarrhea (14%), abnormal liver function tests (12%), flu syndrome (12%), and injection-site reaction (11%).

Lipohypertrophy has been reported in patients treated with SOMAVERT; therefore, injection sites should be rotated daily.

The maximum indicated daily maintenance dose for SOMAVERT is 30 mg.

Rx only


Please scroll for Important Safety Information and Indication

INDICATION

SOMAVERT® (pegvisomant for injection) is indicated for the treatment of acromegaly in patients who have had an inadequate response to surgery or radiation therapy, or for whom these therapies are not appropriate. The goal of treatment is to normalize serum insulin-like growth factor-I (IGF-I) levels.

IMPORTANT SAFETY INFORMATION FOR SOMAVERT

SOMAVERT is contraindicated in patients with a history of hypersensitivity to any of its components.

Patients on opioids often needed higher serum pegvisomant concentrations to achieve appropriate IGF-I suppression compared with patients not receiving opioids.

Patients with acromegaly and diabetes mellitus being treated with insulin and/or oral hypoglycemic agents may require dose reductions of these therapeutic agents after the initiation of treatment with SOMAVERT.

Important safety information regarding liver test monitoring
Baseline serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), and alkaline phosphatase (ALP) levels should be obtained prior to initiating therapy with SOMAVERT. Monitor liver tests based on baseline values and changes during therapy according to the schedule in the full Prescribing Information.

Asymptomatic, transient elevations in transaminases up to 15 times ULN have been observed in <2% of subjects among two open-label trials (with a total of 147 patients). These reports were not associated with an increase in bilirubin. Transaminase elevations normalized with time, most often after suspending treatment. If a patient develops liver test elevations, or any other symptoms of liver dysfunction while receiving SOMAVERT, please see Liver Tests section of the full Prescribing Information.

In subjects with systemic hypersensitivity reactions, caution and close monitoring should be exercised when re-initiating SOMAVERT therapy.

The most common adverse events (>6% and at frequencies greater than placebo) in 1 of the 3 active treatment arms in a placebo-controlled study (N=112) included infection (23%), pain (14%), nausea (14%), diarrhea (14%), abnormal liver function tests (12%), flu syndrome (12%), and injection-site reaction (11%).

Lipohypertrophy has been reported in patients treated with SOMAVERT; therefore, injection sites should be rotated daily.

The maximum indicated daily maintenance dose for SOMAVERT is 30 mg.

Rx only