Somavert
Somavert (pegvisomant) is a growth hormone receptor antagonist that's used to treat acromegaly in certain adults. It's administered as an injection under the skin once daily. This medication must be prepared before it's injected; it comes as a powder in a vial that you must mix with the diluent inside the provided prefilled syringe. Side effects include infections and nausea. Somavert (pegvisomant) isn't currently available as a lower-cost generic.
What is Somavert (pegvisomant)?
What is Somavert (pegvisomant) used for?
- Acromegaly in people who either can't get surgery or radiation, or for whom surgery or radiation didn't work well
How Somavert (pegvisomant) works
Somavert (pegvisomant) is a growth hormone receptor antagonist. It works by stopping growth hormone (GH) in your body from attaching to its receptors, which stops the hormone from working. This eases some symptoms of acromegaly, a condition that's caused by having too much GH in the body.
Drug facts
Side effects of Somavert (pegvisomant)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Common cold, upper respiratory infection, or ear infection (up to 23%)
- Pain (up to 14%)
- Nausea (up to 14%)
- Diarrhea (up to 14%)
- Liver problems (up to 12%)
- Flu-like symptoms (up to 12%)
- Injection site reactions (up to 11%)
Less Common Side Effects
- Dizziness
- Back pain
- Chest pain
- Sinus infection
- Swelling in arms and legs
- Tingling sensation
- High blood pressure
Somavert (pegvisomant) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Dangerously low blood sugar: feeling faint or dizzy; shaking; sweating; fast heartbeat; feeling nervousness, anxious, confused, irritable, or very hungry
- Liver problems: yellowing of your skin or the whites of your eyes, confusion, fatigue, low appetite, nausea, vomiting, stomach discomfort
- Severe allergic reaction: difficulty breathing; rash; swelling in your face, tongue, or lips
The following Somavert (pegvisomant) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bleeding, blistering, burning, coldness, or discoloration of skin at site of injection
bloating or swelling of face, arms, hands, lower legs, or feet
blurred vision
chills
dizziness
feeling of pressure
headache
hoarseness
infection, inflammation, itching, or lump at site of injection
nervousness
lower back or side pain
painful or difficult urination
pounding in the ears
rapid weight gain
slow or fast heartbeat
tingling of hands or feet
unusual weight gain or loss
Less common
Thickening of the skin
Incidence not known
Abdominal pain or tenderness
clay colored stools
dark urine
decreased appetite
loss of appetite
skin rash
unusual tiredness or weakness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Accidental injury
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
general feeling of discomfort or illness
joint pain
muscle aches and pains
pain or tenderness around eyes and cheekbones
runny or stuffy nose
shivering
shortness of breath or troubled breathing
sweating
tightness of chest or wheezing
trouble sleeping
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Somavert (pegvisomant)
Pros
- Works well for treating acromegaly
- Given just once per day
- Few drug interactions
Cons
- Medication needs to be prepared and then injected under the skin, which can be inconvenient and difficult for some people
- Doesn't have a long-acting version like other injectable medications for acromegaly
- Available as a brand name only
Pharmacist tips for Somavert (pegvisomant)
- Your first Somavert (pegvisomant) injection will be given by your provider at the office. Then, your provider will train you on how to give yourself the rest of your injections at home.
- Mark your calendar with your appointments to see your provider and get any blood tests done during treatment with Somavert (pegvisomant). This helps make sure your treatment and your hormone levels can be properly monitored.
- Somavert (pegvisomant) can cause very low blood sugar. Always keep emergency glucose tablets or hard candy with you in case your blood sugar drops too low. Make sure you and your loved ones know how to recognize and treat low blood sugar. Check your blood sugar right away if you feel faint or shaky or are sweating. Call 911 if your symptoms don't improve after treating your low blood sugar.
- Somavert (pegvisomant) can raise the risk of unintended pregnancies if you're able to become pregnant. If you're sexually active, ask your provider about what birth control options are best for you.
- Tell your provider or pharmacist about all the medications you're taking, especially blood sugar medications or opioid pain medications. Somavert (pegvisomant) can interact with these types of medications. Don't start any new medications while you're taking Somavert (pegvisomant) without talking to your provider or pharmacist first.
Tips for how to inject Somavert (pegvisomant) at home
- Make sure your provider or pharmacist teaches you how to inject Somavert (pegvisomant) by yourself so that you avoid accidentally hurting yourself or wasting the medication. Carefully read the directions or watch the instructional video on how to mix and inject the medication.
- Store the unopened Somavert (pegvisomant) vials of powder in the refrigerator and away from light. For convenience, you can also store them at room temperature for up to 30 days. Don't put the medication back in the refrigerator once it's at room temperature. The prefilled syringes of diluent (mixing fluid) can be kept at room temperature.
- When it's time for your dose, take the Somavert (pegvisomant) powder out of the refrigerator and lay it on a flat surface to warm up to room temperature. This will take about 10 minutes. Don't try to warm it up any other way, such as with a microwave, because doing so can damage your medication.
- Prepare Somavert (pegvisomant) by injecting the diluent into the vial of powder and swirling the vial to mix. Once mixed, you must use the medication within 6 hours. Ask your provider or pharmacist if you have any questions on how to prepare Somavert (pegvisomant).
- After your injection, throw away any remaining medication in the vial of Somavert (pegvisomant) that you mixed with diluent. Each vial can be used for one dose only. Don't store the medication for later.
- After you've injected Somavert (pegvisomant), throw away the used syringe and needle in a sharps container or something made of heavy-duty plastic, such as a laundry detergent bottle. This helps prevent needle-stick injuries. Don't throw them away in your trash can. Visit the FDA's website website for more information on how to throw away your sharps container safely and guidance for your specific state.
Common questions about Somavert (pegvisomant)
Somavert (pegvisomant) is a growth hormone receptor antagonist. It stops growth hormone (GH) that's made in your body from working by preventing it from attaching to its receptors in the body. Acromegaly is a condition where your body makes too much GH, which is a hormone that plays a role in the growth of your body's organs and tissues. By stopping GH from working in the body, Somavert (pegvisomant) might help to improve certain symptoms of acromegaly.
One of the many effects of growth hormone (GH) in your body is raising blood sugar. In fact, a potential complication of acromegaly is Type 2 diabetes. Since Somavert (pegvisomant) prevents GH from working, it can lower your blood sugar. Check your blood sugar if you experience symptoms of low blood sugar, such as feeling faint, shaking, and sweating. If needed, treat your low blood sugar levels right away. Call 911 if your symptoms or blood sugar levels don't improve.
Somavert (pegvisomant) is given as an injection under the skin in either your thighs, buttocks, or stomach (at least 2 inches away from your belly button). The medication can also be injected under the skin at the back of the upper arm with the help of a healthcare provider or caregiver. Never inject the medication into your muscle or vein. To lower the risk of bruising and skin irritation, rotate between different injection sites so that the same site isn't used repeatedly.
No, Somavert (pegvisomant) doesn't actually change total GH levels.) in your body; it just blocks GH from attaching to its receptors in the body. GH normally tells the body to make another hormone called insulin-like growth factor 1 (IGF-1), which is then responsible for the growth of your body's organs and tissues. After you start treatment with Somavert (pegvisomant), the levels of IGF-1 in your body should go down since the medication works to block GH. This should mean that the medication is working.
Octreotide and Somavert (pegvisomant) are both used to treat acromegaly. But certain brands of octreotide can be used for other conditions as well. The two medications affect growth hormone (GH) in the body in different ways: Somavert (pegvisomant) stops GH from working, whereas octreotide prevents your pituitary gland from releasing GH into the body. Also, Somavert (pegvisomant) is an injection under the skin that'sgiven once a day. But octreotide has multiple formulations — a capsule that's taken by mouth twice daily, an injection under the skin that's given three times daily, or an injection into the muscle once monthly. A study suggested that both medications work just as well as each other for acromegaly, but Somavert (pegvisomant) might have a more beneficial effect on blood sugar than octreotide. Talk to your provider about which medication is right for you.
Somavert (pegvisomant) hasn't been well studied in human pregnancy, so it's not known whether this medication is safe or works well during pregnancy. Some animal studies showed that unborn babies were harmed when their mothers were injected with Somavert (pegvisomant) during pregnancy at doses 6 times higher than the dose typically used in humans. Talk with your provider about the risks and benefits of using Somavert (pegvisomant) if you're pregnant or thinking of becoming pregnant.
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Risks and warnings for Somavert (pegvisomant)
Somavert (pegvisomant) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood sugar
- Risk factors: Blood sugar problems | Taking medications for Type 2 diabetes
Somavert (pegvisomant) can make you more sensitive to insulin. This can put you at risk for low blood sugar, especially if you're taking medications to lower blood sugar.
Your provider might have you keep track of your blood sugar regularly, especially when you first start Somavert (pegvisomant) and when there's a change in your dose. You also might need dose adjustments for any blood sugar medications that you're already taking.
Make sure you can recognize signs of low blood sugar, such as feeling faint or dizzy, shaking, and sweating. It's important to treat low blood sugar right away and get medical help if your symptoms don't improve because it can lead to dangerous complications. Talk with your provider if you have any symptoms of or questions about blood sugar problems.
Liver problems
Some people who took Somavert (pegvisomant) developed liver problems. You'll need to get regular blood tests done before and during treatment to make sure your liver is working properly, even if you don't feel any symptoms of liver damage. Be sure to get medical attention right away if you notice yellowing of your skin or the whites of your eyes, fatigue, low appetite, nausea, vomiting, or stomach discomfort. If this happens, you might need to stop using the medication to prevent further liver damage.
Fatty lumps under the skin
Although rare, injections under the skin, like with Somavert (pegvisomant), can cause fatty lumps to appear under your skin around the area where you injected the medication. Make sure you're injecting into a different site than the previous injection to prevent fatty lumps from forming under your skin.
Somavert (pegvisomant) dosage
Typical dosage for Somavert (pegvisomant)
- Starting dose: The typical starting dose is 40 mg injected under the skin on day 1, then 10 mg injected once per day starting on day 2.
- Maintenance dose: The typical maintenance dose ranges from 10 mg to 30 mg injected under the skin once per day. Your provider might change your dose depending on the levels of a hormone called IGF-1 in your body. The maximum dose is 30 mg once per day.
Interactions between Somavert (pegvisomant) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
What are alternatives to Somavert (pegvisomant)?
Pasireotide can be used in adults to treat these conditions if surgery isn't an option or haven't worked well: