Drug Action
Pegvisomant is a genetically modified analogue of human growth hormone and is a highly selective growth hormone receptor antagonist.
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Drug reference
Pegvisomant is a genetically modified analogue of human growth hormone and is a highly selective growth hormone receptor antagonist.
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Treatment of acromegaly in patients with inadequate response to surgery, radiation, or both, and to treatment with somatostatin analogues (initiated by a specialist) ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 80 mg for 1 dose, followed by 10 mg daily, then increased in steps of 5 mg daily, adjusted according to response; maximum 30 mg per day
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Abnormal liver function tests and/or signs or symptoms of liver injury (further investigations may be required before treatment initiation—consult product literature). diabetes mellitus (adjustment of antidiabetic therapy may be necessary)
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Scottish Medicines Consortium (SMC) decisions The Scottish Medicines Consortium has advised (November 2017) that pegvisomant (Somavert ®) is accepted for use within NHS Scotland for the treatment of patients with acromegaly who have had an inadequate response to surgery and/or radiation therapy and in whom an appropriate medical treatment with somatostatin analogues did not normalise IGF-1 [insulin-like growth factor 1] concentrations or was not tolerated. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower. All Wales Medicines Strategy Group (AWMSG) decisions The All Wales Medicines Strategy Group has advised (November 2017) that pegvisomant (Somavert ®) is recommended as an option for use within NHS Wales for the treatment of patients with acromegaly who have had an inadequate response to surgery and/or radiation therapy and in whom an appropriate medical treatment with somatostatin analogues did not normalise insulin- like growth factor-1 (IGF-1) concentrations or was not tolerated. This recommendation applies only in circumstances where the approved Wales Patient Access Scheme (WPAS) is utilised or where the list/contract price is equivalent or lower than the WPAS price.
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▶Common or very common Arthralgia. arthritis. asthenia. constipation. diarrhoea. dizziness. drowsiness. dyslipidaemia. dyspnoea. eye pain. fever. gastrointestinal discomfort. gastrointestinal disorders. haemorrhage. headaches. hyperglycaemia. hypertension. hypoglycaemia. influenza like illness. lipohypertrophy. myalgia. nausea. numbness. oedema. skin reactions. sleep disorders. sweat changes. tremor. vomiting. weight increased ▶Uncommon Apathy. confusion. dry mouth. eye strain. feeling abnormal. healing impaired. hunger. leucocytosis . leucopenia. libido increased. memory loss. Meniere’s disease. oral disorders. panic attack. polyuria. proteinuria . renal impairment. taste altered. thrombocytopenia ▶Frequency not known Anger. angioedema. hepatic function abnormal. laryngospasm SIDE-EFFECTS, FURTHER INFORMATION Injection-site reactions Rotate injection sites to avoid lipohypertrophy. Abnormal hepatic function Manufacturer advises interrupt treatment if liver function tests at least 5 times the upper limit of normal or transaminase levels at least 3 times the upper limit of normal and blood bilirubin increased—consult product literature. Discontinue if liver injury is confirmed.
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Possible increase in female fertility.
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Avoid.
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Avoid.
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Manufacturer advises caution (no information available); temporary or permanent withdrawal may be needed—consult product literature.
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▶Manufacturer advises assess liver function tests before treatment initiation and monitor liver function tests during treatment—consult product literature. ▶Manufacturer advises monitor serum IGF-I concentrations.
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There can be variation in the licensing of different medicines containing the same drug. Powder and solvent for solution for injection ▶Somavert (Pfizer Ltd) Pegvisomant 10 mg Somavert 10mg powder and solvent for solution for injection vials | 30 vial P £1,500.00 (Hospital only) Pegvisomant 15 mg Somavert 15mg powder and solvent for solution for injection vials | 30 vial P £2,250.00 (Hospital only) Pegvisomant 20 mg Somavert 20mg powder and solvent for solution for injection vials | 1 vial P £100.00 (Hospital only) | 30 vial P £3,000.00 (Hospital only) Pegvisomant 25 mg Somavert 25mg powder and solvent for solution for injection vials | 30 vial P £3,750.00 (Hospital only) Pegvisomant 30 mg Somavert 30mg powder and solvent for solution for injection vials | 30 vial P £4,500.00 (Hospital only) PITUITARY AND HYPOTHALAMIC HORMONES AND ANALOGUES › HUMAN GROWTH HORMONES
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Initially 80 mg for 1 dose, followed by 10 mg
First-line fragment. Read the complete Indications and Dose section above.
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