[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Somatostatin analogues](https://durgical.com/en/pharmacology/classes/somatostatin-analogues/) › Pasireotide

# Pasireotide

## Somatostatin analogues?

Somatostatin analogues

A somatostatin analogue that reaches more receptor types, including SSTR5. It lowers ACTH and cortisol in Cushing's disease, and GH in acromegaly.

Updated Nov 1, 2026

## Quick facts

**Group**
[Somatostatin analogues](https://durgical.com/en/pharmacology/classes/somatostatin-analogues/)

**Target**
Somatostatin receptors, highest affinity for SSTR5

**Used for**
Cushing's disease

**Key effects**
Hyperglycaemia and diabetes · Diarrhoea · Headache

**Monitor**
Fasting glucose and HbA1c before · Cortisol · ECG

**ATC**
H01CB05

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Somatostatin receptors, highest affinity for SSTR5**Pasireotide

ⓘ The figure shows pasireotide itself bound to the human SSTR5 receptor with its Gi protein (cryo-EM).

**Target in 3D:** Somatostatin receptors, highest affinity for SSTR5. PDB structure 8ZCJ (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8ZCJ) · Drag to rotate · pinch to zoom

Pasireotide binds four of the five somatostatin receptor types (1, 2, 3 and 5), with its highest affinity for SSTR5, which corticotroph adenomas express. Through these Gi-coupled receptors it inhibits ACTH secretion, so cortisol falls in Cushing's disease, and it inhibits growth hormone secretion in acromegaly. It also lowers insulin and the incretins GLP-1 and GIP, so blood glucose usually rises.

- Pasireotide binds SSTR5 (and SSTR1, 2, 3)
- Corticotroph ACTH and somatotroph GH secretion fall
- Cortisol and IGF-1 decrease
- Insulin and incretins fall, so glucose rises

## Indications

- Cushing's disease in adults who cannot have pituitary surgery or were not cured by it [Cushing syndrome →](https://durgical.com/en/conditions/cushing-syndrome/)
- Acromegaly when surgery is not an option or has not worked (long-acting form) [Acromegaly and gigantism →](https://durgical.com/en/conditions/acromegaly-and-gigantism/)

## Adverse effects

### Common

- Hyperglycaemia and diabetes, common and often needing treatment
- Diarrhoea, nausea, abdominal pain
- Injection-site reactions
- Headache, tiredness and hair loss

### Serious (rare, important)

- Hypocortisolism (adrenal insufficiency)
- Bradycardia and QT prolongation
- Gallstones and their complications
- Liver test abnormalities with jaundice

## Contraindications

- Hypersensitivity to pasireotide
- Caution: uncontrolled diabetes, recent heart attack, heart failure, long QT, uncorrected low potassium or magnesium

## Key interactions

**Insulin and oral antidiabetic drugs**
Hyperglycaemia often needs new or intensified treatment

**Other drugs that prolong the QT interval or slow the heart**
Additive QT prolongation and bradycardia

## What is monitored

- Fasting glucose and HbA1c before and during treatment
- Cortisol (Cushing's) or GH and IGF-1 (acromegaly)
- ECG, potassium and magnesium
- Liver tests and gallbladder symptoms

## Administration and safety

- Two forms that are not interchangeable: subcutaneous solution and intramuscular long-acting suspension
- The subcutaneous form may be given at home after training; the intramuscular form is given into the buttock by a health professional
- Look-alike risk with octreotide and lanreotide: confirm the drug and form

## Pregnancy and breastfeeding

Information in pregnancy is limited. As cortisol falls, fertility may recover and unplanned pregnancy becomes possible.

## Nursing care

- Check glucose regularly and teach the signs of high blood sugar
- Teach the signs of low cortisol: tiredness, weakness, nausea, dizziness
- Check heart rate and ECG results
- Advise reliable contraception if pregnancy is not wanted, since fertility may improve

## Pharmacokinetics

**Absorption**
Short-acting solution given subcutaneously; long-acting suspension given intramuscularly

## Memory aid

PASIreotide PASSES to SSTR5: hits corticotrophs (Cushing's) but takes the incretins down, so sugar goes up.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does pasireotide work in Cushing's disease when octreotide usually does not?

Corticotroph adenomas express mainly SSTR5, and pasireotide has its highest affinity for SSTR5.

## Why does pasireotide often cause hyperglycaemia?

It suppresses insulin and the incretins GLP-1 and GIP, so glucose tolerance worsens more than with other analogues.

## Which hormone deficiency can pasireotide cause in Cushing's disease?

Hypocortisolism (adrenal insufficiency) from excessive ACTH suppression.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/pasireotide/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 4

- [Octreotide](https://durgical.com/en/pharmacology/octreotide/)
- [Lanreotide](https://durgical.com/en/pharmacology/lanreotide/)
- [Osilodrostat](https://durgical.com/en/pharmacology/osilodrostat/)
- [Metyrapone](https://durgical.com/en/pharmacology/metyrapone/)

## Related conditions 2

- [Cushing syndrome](https://durgical.com/en/conditions/cushing-syndrome/)
- [Acromegaly and gigantism](https://durgical.com/en/conditions/acromegaly-and-gigantism/)

[← Back to the class: Somatostatin analogues](https://durgical.com/en/pharmacology/classes/somatostatin-analogues/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Pasireotide Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a622029.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H01CB05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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