Pituitary disorders:

Indications for SIGNIFOR LAR:

Treatment of patients with acromegaly who have had an inadequate response to surgery and/or for whom surgery is not an option.


Give by IM inj into the right or left gluteus. Initially 40mg every 4 weeks (28 days); may increase dose to max 60mg after 3 months if GH and/or IGF-1 levels not normalized. If over-response to treatment, may decrease in 20mg decrements. Hepatic impairment: moderate (Child-Pugh B): initially 20mg every 4 weeks; max: 40mg every 4 weeks; severe (Child-Pugh C): avoid.


<18yrs: not established.


Monitor for adrenal insufficiency; give steroid replacement therapy if confirmed. Risk of hyperglycemia; initiate or adjust antidiabetic treatment if occurs; reduce dose or discontinue if remains uncontrolled. Monitor HbA1c and FPG prior to initiation, weekly for first 3 months, 4–6 weeks after dose increase, and thereafter as indicated. Congenital long QT prolongation. Cardiac disease (eg, recent MI, CHF, unstable angina, significant bradycardia); monitor QT interval at 21 days. High-grade heart block. Hypokalemia and/or hypomagnesemia; correct and monitor electrolytes prior to starting and during therapy. Monitor liver tests prior to initiation, 2–3 weeks after, then monthly for 3 months, then as indicated. Discontinue if significant hepatic impairment develops. Monitor baseline ECG, pituitary function prior to initiation and periodically during treatment. Renal impairment: not studied. Premenopausal women: potential for unintended pregnancy due to improved fertility. Pregnancy. Nursing mothers.

Pharmacologic Class:

Cyclohexapeptide somatostatin analog.


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.

Adverse Reactions:

Diarrhea, hyperglycemia, diabetes, cholelithiasis (monitor); bradycardia, QT prolongation, pituitary hormone deficiency.

Generic Availability:


How Supplied:

Single-use kit—1 (w. diluents, supplies)