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Acromegaly

Updated : July 12, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

lanreotide

90

mg

every 4 weeks

3

months

Initial dose



lanreotide

Maintenance dose: based on the clinical response of the patient.



Dose Adjustments

Growth hormone <1mg/ml: 60 mg once every 4 weeks
Growth hormone >1 to 2.5 ng/ml: 90 mg once every 4 weeks
Growth hormone >2.5 ng/ml: 120 mg once every 4 weeks.

pasireotide

Initial IM dose:

40

mg

once every 4 weeks (dose can be adjusted according to levels of growth hormone to 60 mg once every 4 weeks after >3 months if levels are normalized. Decrease the dose to 20 mg if adverse effects occur.)
Do not administer missed dose 2 weeks prior to the next dose.



bromocriptine

Initial dose:

1,25 - 2.5

mg

Orally

once a day

dose can be increased up to 1.25 to 2.5 mg as tolerated every 3 to 7 days
Maintenance dose: 20 to 30 mg once a day
Maximum dose: 100 mg once a day



pegvisomant 

At the start, administer 10 mg SC one time daily
Administer 40 mg SC one time daily as a loading dose under the guidance of a medical practitioner
Administer 10 mg-30 mg SC one time daily as a maintenance dose
Administer 30 mg daily as maximum dose



vapreotide 

Indicated for Bleeding esophageal varices
:


Administer 50 microgram (mcg) intravenous bolus, then continue the infusion for five days at a rate of 50 mcg per hour. After starting the continuous infusion, endoscopic therapy was supposed to start within 12 hours.



 
 

Media Gallary

References

Acromegaly

Updated : July 12, 2022




lanreotide

90

mg

every 4 weeks

3

months

Initial dose



lanreotide

Maintenance dose: based on the clinical response of the patient.



Dose Adjustments

Growth hormone <1mg/ml: 60 mg once every 4 weeks
Growth hormone >1 to 2.5 ng/ml: 90 mg once every 4 weeks
Growth hormone >2.5 ng/ml: 120 mg once every 4 weeks.

pasireotide

Initial IM dose:

40

mg

once every 4 weeks (dose can be adjusted according to levels of growth hormone to 60 mg once every 4 weeks after >3 months if levels are normalized. Decrease the dose to 20 mg if adverse effects occur.)
Do not administer missed dose 2 weeks prior to the next dose.



bromocriptine

Initial dose:

1,25 - 2.5

mg

Orally

once a day

dose can be increased up to 1.25 to 2.5 mg as tolerated every 3 to 7 days
Maintenance dose: 20 to 30 mg once a day
Maximum dose: 100 mg once a day



pegvisomant 

At the start, administer 10 mg SC one time daily
Administer 40 mg SC one time daily as a loading dose under the guidance of a medical practitioner
Administer 10 mg-30 mg SC one time daily as a maintenance dose
Administer 30 mg daily as maximum dose



vapreotide 

Indicated for Bleeding esophageal varices
:


Administer 50 microgram (mcg) intravenous bolus, then continue the infusion for five days at a rate of 50 mcg per hour. After starting the continuous infusion, endoscopic therapy was supposed to start within 12 hours.



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