Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Signifor (Pasireotide).

Abnormal heart rhythms: Signifor (Pasireotide) can cause abnormal heart rhythms. Certain medications (e.g., Sotalol, quinidine, thioridazine, Chlorpromazine, l, Pimozide, moxifloxacin, Mefloquine, pentamidine, arsenic trioxide, Tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with Signifor (Pasireotide). You are more at risk for this type of abnormal heart rhythm and its complications if you:

• are female
• are older than 65 years of age
• have a family history of sudden cardiac death
• have a history of heart disease or abnormal heart rhythms
• have a slow heart rate
• have congenital prolongation of the QT interval
• have diabetes
• have had a Stroke
• have low potassium, magnesium, or calcium levels
• have nutritional deficiencies

If you have heart disease and abnormal heart rhythms, or are taking certain medications (e.g., Verapamil, atazanavir), discuss with your doctor how Signifor (Pasireotide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Signifor (Pasireotide), and whether any special monitoring is needed.

Diabetes: Signifor (Pasireotide) often causes increased blood sugar levels, causing the loss of blood glucose control. Glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Signifor (Pasireotide). Your doctor should monitor your blood glucose levels regularly when you first start using Signifor (Pasireotide), even if you do not have diabetes.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Signifor (Pasireotide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Signifor (Pasireotide), and whether any special monitoring is needed.

Fluid and electrolyte balance: Signifor (Pasireotide) may cause the levels of electrolytes such as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking Signifor (Pasireotide). If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood while you are taking Signifor (Pasireotide).

Liver function: People taking Signifor (Pasireotide) may have changes in liver function that produce abnormal liver test results. Your doctor will recommend regular liver tests while you are taking Signifor (Pasireotide). Liver disease or reduced liver function may cause Signifor (Pasireotide) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Signifor (Pasireotide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Signifor (Pasireotide), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Signifor (Pasireotide).

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low levels of cortisol: Treatment with Signifor (Pasireotide) causes a decrease in the amount of cortisol produced by the body. Cortisol is a hormone the body needs to function.

If the amount of cortisol in the body is reduced too much, it can cause weakness, fatigue, loss of appetite, nausea, vomiting, low blood pressure, low blood glucose, and low amounts of sodium in the body.

Pancreatitis: Signifor (Pasireotide) can cause the pancreas to become inflamed. If you have a history of pancreatitis, discuss with your doctor how Signifor (Pasireotide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Signifor (Pasireotide), and whether any special monitoring is needed.

Report signs of pancreatitis such as abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, or swollen abdomen to your doctor immediately.

Pregnancy: The potential risks of using Signifor (Pasireotide) during pregnancy, for the mother or developing baby, are not known. Women who may become pregnant should not use Signifor (Pasireotide) unless they are using reliable birth control. If you become pregnant while taking Signifor (Pasireotide), contact your doctor immediately.

Breast-feeding: It is not known if Signifor (Pasireotide) passes into breast milk. If you are a breast-feeding mother and are taking Signifor (Pasireotide), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Signifor (Pasireotide) have not been established for children.