Medical treatment is used to keep growth hormone and IGF-1 levels within the normal range, and to prevent growth hormone exerting its effect on the body. They may also reduce the size of your pituitary tumour, although this is not their main effect.
Medications may be used before surgery to help manage your symptoms or instead of surgery.
When used after surgery the aim is to reduce growth hormone and IGF-1 levels further, and also to control your symptoms.
Occasionally, surgery may not be suitable for some people or they may not want to have surgery at all.
There are three groups of medicines used to treat acromegaly: somatostatin analogues, dopamine agonists, and a growth hormone receptor antagonist.
Somatostatin analogues are synthetic versions of somatostatin, which reduce the release of growth hormone. They are given via subcutaneous injection, deep subcutaneous injection or intramuscular injection, depending on the drug administered.
Dopamine agonists can also help to reduce the release of growth hormone in the body. These are given as tablets at least once a week but more usually on several days each week.
There is only one growth hormone receptor antagonist available at present. It is given by subcutaneous injection and works by preventing growth hormone from having an effect on the body by reducing the production of IGF-1 by the liver.
Somatostatin analogues, dopamine agonists, and a growth hormone receptor antagonist are generally used alone but sometimes they can be used together, although such an approach is not always allowed in every country.
How these drugs are given and how frequently they are given depends on the type of drug your doctor prescribes to you and how long its effects in the body will last (known as the duration of action).
Please remember that medical treatment for acromegaly may vary from country to country. A healthcare professional will be able to advise you on the drug classes that are available in your country.
All medicines have side effects, some of which may wear off with time.
It is important to read the patient information leaflet inside the medicine pack at your treatment is started and also from time to time while being treated to check that you understand how it works and the possible side effects that may occur.
It is also important that you report any side effects you experience to the healthcare professional who prescribed your treatment in case your treatments needs to be revised. He or she may also need to pass on this information to the manufacturer of the medicine and local health authority if necessary.
The most common side effects of somatostatin analogues are diarrhoea, abdominal pain and feeling sick (nausea).
In addition, other common side effects may include wind (flatulence), bloating, and feeling pain at the site of injection.
Higher than normal blood glucose levels may also occur with newer somatostatin analogues when given as a long-acting injection.
Feeling sick (nausea) is a common side effect of treatment with a dopamine agonist.
Other side effects include feeling ‘light headed’, drowsiness, constipation and headache, although all are uncommon.
The most common side effects with a growth hormone receptor antagonist are injection site reactions, sweating, headache, muscle weakness and increases in liver enzymes. Your doctor will check your blood at intervals to check that your liver enzymes remain within normal limits during your treatment.
Speak to your endocrinologist or other member of your healthcare team if you would like more information about the medications to treat acromegaly and their specific side effects. Patient organisations also often produce information booklets that outline the various treatment choices available in your country.
Read and hear answers to some common questions that patients with acromegaly have asked
Find an acromegaly patient support group in your country to find out about local activities and events that you may be able to attend
Information about the emotional, physical and social challenges of living with acromegaly