Movantik® (pasireotide)
Formulation: 25 mg sublingual tablet (tablet or film‑like strip that is placed under the tongue).
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1. What is Movantik?
- Drug class: Somatostatin analogue (pasireotide) that acts on somatostatin receptors 2 and 5.
- Brand name: Movantik® (generic: pasireotide).
- Approved indications (as of 2024):
- Refractory pruritus (itching) that is unresponsive to antihistamines, topical corticosteroids, or other standard treatments, associated with chronic kidney disease (CKD) or end‑stage renal disease (ESRD) and the patient is not a candidate for dialysis.
- (In some jurisdictions, it is also used for severe, chronic pruritus of renal origin in patients who are not candidates for dialysis.)
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2. How is it taken?
- Route: Sublingual (under the tongue).
- Typical schedule: Once daily (usually at bedtime).
- Administration technique: Place the tablet under the tongue, allow it to dissolve completely (do not chew, swallow, or rinse the mouth).
- Food interactions: Food does not significantly affect absorption, but it is usually taken with or without food as tolerated.
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3. When is it NOT used?
- Contraindications
- Known hypersensitivity to pasireotide or any excipient.
- Severe hepatic impairment (liver function tests >5 × upper limit of normal).
- Active, uncontrolled diabetes mellitus (pasireotide can worsen glycemic control).
- Precautions
- Diabetes: Monitor fasting glucose and HbA1c closely; insulin or oral hypoglycemics may need adjustment.
- Pregnancy & breastfeeding: Not recommended; limited data on fetal safety.
- Renal function: While approved for CKD/ESRD patients, avoid in patients with acute renal failure or rapidly deteriorating kidney function.
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4. Common side‑effects
| Category | Examples | Typical severity |
|----------|----------|------------------|
| Gastro‑intestinal | Nausea, vomiting, diarrhea, abdominal pain | Mild‑moderate; usually transient |
| Endocrine | Hyperglycemia, hypoglycemia, decreased thyroid hormone | Mild‑moderate; requires monitoring |
| Metabolic | Lipid changes, weight gain | Mild‑moderate |
| Dermatologic | Rash, pruritus (counterintuitive, but rare) | Mild |
| Ophthalmic | Dry eye, blurred vision | Mild |
| Hepatic | Elevated liver enzymes | Rare, usually mild |
If you notice worsening or persistent itching, new rashes, or significant changes in blood sugars, contact your healthcare provider promptly.
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5. Drug–drug interactions
| Interacting drug | What to watch for | Typical action |
|------------------|-------------------|----------------|
| Insulin / oral hypoglycemics | Hyperglycemia | May need dose adjustment |
| Other somatostatin analogues (octreotide, lanreotide) | Overlap of action; additive effects | Use with caution |
| Cytochrome P450 inhibitors/inducers (e.g., ketoconazole, rifampicin) | Altered plasma levels | Monitor for efficacy / toxicity |
| NSAIDs | GI irritation | Monitor GI tolerability |
| Antihyperglycemics | Combined hyperglycemia risk | Monitor blood sugar closely |
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6. How to store
- Keep at room temperature (≤25 °C), away from direct sunlight and moisture.
- Keep out of reach of children.
- Do not refrigerate unless instructed by a pharmacist.
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7. What to do in case of an overdose
- Immediate action: Seek emergency medical care.
- Symptoms: Nausea, vomiting, dizziness, or any unusual change in alertness.
- Management: Supportive care; monitor vital signs; treat hyperglycemia if present.
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8. Key points for patients
| ✅ | What you should know |
|----|---------------------|
| Take as directed – usually once daily, under the tongue, at bedtime. |
| Monitor your blood sugars – especially if you’re on diabetes meds. |
| Report side‑effects – mild GI upset is common; more serious symptoms like persistent itching, rash, or severe GI pain need medical attention. |
| Keep a medication diary – note timing, dose, and any side‑effects or changes in itching. |
| Do not skip doses – consistent dosing improves efficacy. |
| Talk to your prescriber before starting any new medication, especially if you have liver disease, diabetes, or are pregnant/breastfeeding. |
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9. Where can you get more help?
- Prescription & dosage – Discuss with your prescribing clinician.
- Side‑effect monitoring – Regular follow‑up visits or telehealth check‑ins.
- Patient support programs – Many manufacturers offer patient assistance, counseling, and educational resources.
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Quick reference
- Brand: Movantik®
- Generic: Pasireotide
- Dose: 25 mg sublingual tablet
- Indication: Refractory pruritus in CKD/ESRD patients unsuitable for dialysis
Feel free to ask if you have any other questions—whether about dosing schedules, monitoring, or how it compares to other pruritus treatments!