Mycapssa is a brand-name prescription drug. It’s FDA-approved to treat acromegaly in certain adults. Acromegaly is a condition that causes excess growth of bones and tissues.

Mycapssa is prescribed as a maintenance treatment. This means that you would use Mycapssa after your acromegaly symptoms have already been managed with certain other drugs. For more information about how to use the drug, see the “Mycapssa uses” section below.

Drug details

Mycapssa contains the active drug octreotide, which is a synthetic (human-made) version of a natural hormone called somatostatin. Mycapssa works by acting like somatostatin in your body. For more information, see the “How Mycapssa works” section below.

Mycapssa comes as a capsule that you swallow. It’s available in one strength: 20 milligrams (mg). You’ll likely take Mycapssa twice per day.

FDA approval

In 2020, the Food and Drug Administration (FDA) approved Mycapssa to treat acromegaly in adults. Mycapssa is the first oral form of octreotide to receive FDA approval. Currently, Mycapssa is the only approved oral form of octreotide. Other octreotide drugs are given as injections.

Effectiveness

For information about the effectiveness of Mycapssa, see the “Mycapssa uses” section below.

Mycapssa is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Mycapssa contains the active drug octreotide.

As with all medications, the cost of Mycapssa can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Mycapssa. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

It’s important to note that you’ll have to get Mycapssa through a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to ensure you use them safely and effectively.

Before approving coverage for Mycapssa, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if they will cover the drug.

If you’re not sure if you’ll need to get prior authorization for Mycapssa, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Mycapssa, or if you need help understanding your insurance coverage, help is available.

Chiasma, Inc., the manufacturer of Mycapssa, offers a program called Chiasma Access & Patient Support (CAPS). For more information and to find out if you’re eligible for support, call 833-3GO-CAPS (833-346-2277) or email CAPS@chiasmapharma.com.

Mail-order pharmacies

Mycapssa may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Mycapssa, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Mycapssa is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The Mycapssa dosage your doctor prescribes will depend on several factors. These include:

  • certain lab tests
  • other medical conditions you may have
  • other medications you’re taking

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Mycapssa comes as a capsule that you swallow. It’s available in one strength: 20 milligrams (mg). Mycapssa is the first oral form of octreotide to receive approval from the Food and Drug Administration (FDA). Currently, Mycapssa is the only approved oral form of octreotide. Other octreotide drugs are given as injections.

Dosage for acromegaly

Mycapssa is approved to treat acromegaly* in certain adults. The drug is prescribed after acromegaly symptoms have already been controlled with certain other drugs.†

The typical starting dose of Mycapssa is 20 milligrams (mg) twice per day. You’ll usually take the drug on an empty stomach, at least 1 hour before or 2 hours after a meal. The maximum recommended dose is 40 mg twice per day.

Acromegaly is caused by high levels of a hormone called insulin-like growth factor-1 (IGF-1). To determine the right dosage for you, your doctor will typically order lab tests to track your IGF-1 levels and symptoms every 2 weeks. Your doctor may continue to adjust your dosage until your IGF-1 levels are balanced and your symptoms are well-managed. At that point, your doctor will likely prescribe you a steady dose of Mycapssa.

Also, your doctor may prescribe a different dosage depending on other factors, including whether you have kidney disease. If you have questions about the dosage that’s right for you, talk with your doctor.

* Acromegaly is a condition that causes excess growth of bones and tissues.
† For more information about how to use Mycapssa, see the “Mycapssa uses” section below.

Dosage questions

Below are answers to some questions you may have about taking Mycapssa.

What if I miss a dose?

It’s important that you don’t miss a dose of Mycapssa. A missed dose can make the drug less effective at treating your condition.

If you miss a dose of Mycapssa, skip your missed dose and take your next dose at its usual time. You don’t need to make up for your missed dose or take an extra dose of Mycapssa later.

If you have questions about what to do if you’ve missed a dose of Mycapssa, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

For more ideas about ways to help remember your Mycapssa dose, visit the manufacturer’s site.

Will I need to use this drug long term?

Mycapssa is meant to be used as a long-term treatment. If you and your doctor determine that Mycapssa is safe and effective for you, you’ll likely take it long term.

Mycapssa can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Mycapssa. These lists do not include all possible side effects.

For more information about the possible side effects of Mycapssa, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks the side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Mycapssa, you can do so through MedWatch.

Mild side effects

Mild side effects* that have been reported with Mycapssa include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Mycapssa. To learn about other mild side effects, talk with your doctor or pharmacist, or view Mycapssa’s patient information.
† For more information on this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Mycapssa aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms that have been reported with Mycapssa include:

* For more information about these side effects, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

High or low blood sugar levels

The use of Mycapssa may cause hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). This was one of the most common side effects in clinical studies of this drug. To find out how often this side effect occurred in clinical studies, see the drug’s prescribing information.

High blood sugar explained

Hyperglycemia refers to a blood sugar level that’s above normal. For most people who don’t have diabetes, a normal blood sugar level is below 140 milligrams per deciliter (mg/dL). Symptoms of hyperglycemia typically occur if your blood sugar level is 180 mg/dL or higher. Symptoms can include:

  • headache
  • weight loss
  • blurry vision
  • tiredness
  • feeling more thirsty than usual
  • trouble concentrating
  • urinating more often than usual

Low blood sugar explained

Hypoglycemia refers to a blood sugar level that’s lower than normal. Most people who don’t have diabetes have a normal blood sugar level above 70 mg/dL. Symptoms of hypoglycemia typically occur if your blood sugar level is below 70 mg/dL. Symptoms can include:

Talking with your doctor

If you experience symptoms of hypoglycemia or hyperglycemia while using this drug, talk with your doctor. They may want to monitor your blood sugar levels more closely than usual.

Gallbladder problems

Taking Mycapssa may cause gallbladder problems. This was a common side effect in clinical studies of Mycapssa.

Specific gallbladder problems you might have while taking this drug include:

To find out how often these gallbladder problems occurred in clinical studies, see the drug’s prescribing information.

Symptoms of gallbladder problems may include:

Tell your doctor right away if you experience any symptoms of gallbladder problems while taking Mycapssa. They may want you to you pause your Mycapssa use or switch to a different medication. You may also need other treatment for the gallbladder problem.

Gastrointestinal issues

The use of Mycapssa may cause gastrointestinal (GI) issues. Examples of these issues include:

GI issues were common in clinical studies of Mycapssa. To find out how often these issues occurred in clinical studies, see the drug’s prescribing information.

If you experience bothersome GI issues while taking Mycapssa, talk with your doctor. They can suggest ways to relieve these side effects.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Mycapssa. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, redness, or discoloration in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing
  • chest pain
  • feeling faint
  • rapid heartbeat

Call your doctor right away if you have an allergic reaction to Mycapssa, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The Food and Drug Administration (FDA) approves prescription drugs such as Mycapssa to treat certain conditions. Mycapssa may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

Note: Mycapssa contains the active drug octreotide. Mycapssa is the first oral form of octreotide to receive FDA approval. Currently, Mycapssa is the only approved oral form of octreotide. Other octreotide drugs are given as injections.

Mycapssa for acromegaly

Mycapssa is FDA-approved to treat acromegaly in certain adults. Acromegaly is a condition that causes excess growth of bones and tissues.

Mycapssa is prescribed as a maintenance treatment. This means it’s used after acromegaly symptoms have already been controlled with certain other drugs.

Specifically, Mycapssa is prescribed after initial treatment with one of the following drugs:

About acromegaly

Acromegaly causes excess growth of bones and tissues. This excess growth happens over a long period of time. Acromegaly is rare and is usually diagnosed in middle age.

Acromegaly occurs when your pituitary gland releases too much growth hormone. Your pituitary gland is a small gland located near the bottom of your brain. This condition is usually caused by a noncancerous tumor on the gland.

Growth hormone activates the release of another hormone called insulin-like growth factor-1 (IGF-1) from your liver. IGF-1 can cause the bones and tissues mentioned above to grow excessively.

Symptoms of acromegaly may include:

  • enlarged or darkened skin tags (small growths of hanging skin)
  • an increase in the size of your face, ears, feet, or hands
  • a voice that sounds deeper than usual
  • an increase in body odor
  • an increase in the spaces between your teeth
  • thick, oily, or rough skin
  • sweating more often than usual

Effectiveness for acromegaly

Mycapssa has been found effective in treating acromegaly. Octreotide, the active drug in Mycapssa, is recommended as a treatment option in the Endocrine Society treatment guidelines for acromegaly.

For information on how the drug performed in clinical studies, see Mycapssa’s prescribing information.

Mycapssa and children

Clinical studies haven’t shown if this drug is safe or effective for children.

There aren’t any known interactions between Mycapssa and alcohol.

If you drink alcohol, talk with your doctor about the amount that’s safe for you to consume while taking Mycapssa.

Mycapssa can interact with several other medications. It can also interact with certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Mycapssa and other medications

Below are examples of medications that can interact with Mycapssa. This section does not contain all drugs that may interact with Mycapssa.

Before taking Mycapssa, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Types of drugs that can interact with Mycapssa include:

  • Certain angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors, such as lisinopril (Zestril), are medications used to treat high blood pressure and other heart conditions. Taking Mycapssa with some of these drugs may raise the levels of ACE inhibitors in your blood.
  • Certain birth control medications. Taking Mycapssa with some birth control drugs, such as levonorgestrel (Plan B), can make them less effective for you.
  • Certain digitalis glycosides. Digitalis glycosides, such as digoxin (Lanoxin), are used to treat conditions such as atrial fibrillation and heart failure. Taking Mycapssa with some of these drugs can make digitalis glycosides less effective for you.
  • Certain dopamine receptor agonists. These medications, such as bromocriptine (Parolodel), are used to treat Parkinson’s disease. Taking Mycapssa with some dopamine receptor agonists can raise the level of these drugs in your body.
  • Certain immunosuppressants. Immunosuppressants, such as cyclosporine (Sandimmune), are medications that lessen the activity of your immune system. They’re used to treat conditions such as rheumatoid arthritis (RA) and psoriasis. Taking Mycapssa with some of these drugs can make immunosuppressants less effective.
  • Antacids. Antacids are used to relieve indigestion or heartburn. Taking Mycapssa with these drugs can make Mycapssa less effective. Examples of antacids include:
    • magnesium hydroxide (milk of magnesia)
    • aluminum hydroxide/magnesium hydroxide/simethicone (Mylanta)
  • H2 blockers. These drugs are used to relieve indigestion or heartburn. Taking Mycapssa with H2 blockers, such as cimetidine (Tagamet), can make Mycapssa less effective for you.
  • Proton pump inhibitors (PPIs). PPIs are used to treat conditions such as heartburn or gastroesophageal reflux disease (GERD). Taking Mycapssa with these drugs can make Mycapssa less effective. Examples of PPIs include:

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Mycapssa and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Mycapssa. However, you should still check with your doctor or pharmacist before using any of these products while taking Mycapssa.

Mycapssa and foods

There aren’t any foods that have been specifically reported to interact with Mycapssa.

However, you shouldn’t eat food or drink anything other than water for at least 2 hours before and 1 hour after taking Mycapssa. This is because taking Mycapssa with food lowers the level of the drug in your body. This can make Mycapssa less effective.

Mycapssa may also change the amount of fat your body absorbs from what you eat and drink. Talk with your doctor about how much fat you should consume while taking this drug.

If you have questions about eating certain foods with Mycapssa, talk with your doctor.

You should take Mycapssa according to your doctor’s or healthcare professional’s instructions.

Mycapssa comes as a capsule that you swallow.

When to take

You’ll likely take Mycapssa twice per day. Try to take your doses around the same time each day. This helps your body maintain a steady level of the drug so it can work effectively.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

For ideas about ways to incorporate your Mycapssa dose into your daily routine, visit the manufacturer’s site.

Taking Mycapssa with food

You should avoid eating food for at least 2 hours before and 1 hour after taking Mycapssa. This is because taking the drug with food lowers the level of Mycapssa in your body, which might make it less effective.

Note: You should take Mycapssa with only water. Don’t drink coffee, tea, soda, or anything but water for at least 2 hours before and 1 hour after taking Mycapssa. If you consume drinks other than water in this time frame, the drug could be less effective in treating your condition.

Can Mycapssa be crushed, split, or chewed?

No, you shouldn’t crush, split, or chew Mycapssa. You should swallow each capsule whole.

It’s important that you don’t damage the capsule when removing it from its blister packaging. To gently remove a capsule from its packaging, press lightly on the capsule’s edge using only one thumb.

Acromegaly is a condition that occurs when your pituitary gland releases too much growth hormone. Growth hormone activates the release of another hormone called insulin-like growth factor-1 (IGF-1) from your liver. IGF-1 can cause excess growth of bones and tissues.

Mycapssa contains the active drug octreotide, which is a synthetic (human-made) version of a natural hormone called somatostatin. The main function of somatostatin is to help prevent your body from making certain hormones.

Mycapssa acts like somatostatin in your body. The drug lowers your levels of growth hormone and IGF-1. This decrease in hormone levels helps relieve the symptoms of acromegaly.

How long does it take to work?

Mycapssa starts working right away to treat your condition. But keep in mind that Mycapssa is meant to be used as a maintenance treatment after your acromegaly symptoms are already stable. For this reason, you may not notice Mycapssa working in your body.

Your doctor will typically order certain lab tests to see if the drug is working for you. For more information, see “Will I need to have lab tests done while I’m taking Mycapssa?” in the “Common questions about Mycapssa” section below.

It isn’t known if Mycapssa is safe to use during pregnancy. No studies of Mycapssa have been conducted in pregnancy.

If you’re pregnant or planning a pregnancy, talk with your doctor before starting Mycapssa.

Mycapssa and fertility

Mycapssa isn’t known to affect fertility, which is the ability to become pregnant or cause someone to become pregnant. However, acromegaly may cause infertility in some females.* Acromegaly is a condition that causes excess growth of bones and tissues. And infertility is the inability to become pregnant.

When Mycapssa is used to treat acromegaly, some females whose infertility was caused by the condition are able to become pregnant.

Talk with your doctor if you have questions about your ability to get pregnant while using Mycapssa.

* Use of the terms “female” or “male” within this article refers to a person’s sex assigned at birth.

It’s not known if Mycapssa is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Mycapssa.

For more information about taking Mycapssa during pregnancy, see the “Mycapssa and pregnancy” section above.

It’s not known if Mycapssa can pass into human breast milk. In animal studies, the drug did pass into breast milk. However, animal studies don’t always predict what will happen in humans.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the risks and benefits of using Mycapssa.

Here are answers to some frequently asked questions about Mycapssa.

Will I need to have lab tests done while I’m taking Mycapssa?

Yes, you’ll likely need to have lab tests while you’re using Mycapssa, including ones that measure:

  • IGF-1 hormone. Your doctor will monitor the effectiveness of Mycapssa by measuring levels of insulin-like growth factor-1 (IGF-1) in your body. This is because Mycapssa should decrease the level of this hormone. For more information, see the “Mycapssa uses” section above.
  • Blood sugar. Mycapssa can also cause changes in your glucose (blood sugar) levels. These changes may lead to hypoglycemia, which is low blood sugar, or hyperglycemia (high blood sugar). Therefore, your doctor may monitor your blood sugar levels after you start taking Mycapssa.
  • Thyroid hormone. Mycapssa can also cause hypothyroidism (low levels of thyroid hormone). So, your doctor may want to order thyroid function tests while you’re using this drug.
  • Vitamin B12. Your doctor may also monitor your vitamin B12 levels while you take Mycapssa. This is because the drug may cause your body to absorb less vitamin B12 than usual.

To learn about symptoms of these conditions, see the “Mycapssa side effects” section above.

Talk with your doctor if you have any questions about tests you’ll need during your treatment with Mycapssa.

If I have diabetes, can I take Mycapssa?

It’s possible to take Mycapssa if you have diabetes.

Mycapssa may cause changes in your blood glucose (blood sugar) levels. If you take insulin or other medications to treat your diabetes, your doctor may need to change your dosage of these drugs. Your doctor may also decide to monitor your blood sugar levels more often usual.

If you have questions about using Mycapssa when you have diabetes, talk with your doctor.

Can older people take Mycapssa?

Most likely. Clinical studies of Mycapssa didn’t include enough adults ages 65 years and older to show any differences in effectiveness between this group and younger adults. The effectiveness of Mycapssa in older people is thought to be the same as in younger people.

If you’re concerned about using Mycapssa because of your age, talk with your doctor. They can advise you on the risks and benefits of using this drug and if it’s right for you.

Before taking Mycapssa, talk with your doctor about your health history. Mycapssa may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Diabetes. Tell your doctor if you have diabetes before you start Mycapssa treatment. The drug may cause changes in your blood glucose levels. If you use insulin or other diabetes medications, your doctor may need to change their dosage after you start using Mycapssa. Your doctor may also monitor your blood sugar levels more frequently than usual. For more information, see the “Mycapssa side effects” section above.
  • Irregular heartbeat. Using Mycapssa may cause problems with your heart rate or rhythm. Be sure to tell your doctor if you have an irregular heartbeat before starting Mycapssa treatment. For more information, see the “Mycapssa side effects” section above.
  • Kidney disease. If you have kidney disease, be sure to tell your doctor before you start taking Mycapssa. They’ll likely give you a lower dosage of Mycapssa than is typically used to treat your condition.
  • Allergic reaction. If you’ve had an allergic reaction to Mycapssa or any of its ingredients, you shouldn’t take Mycapssa. Ask your doctor what other medications are better options for you.
  • Pregnancy. It’s not known if Mycapssa is safe to use during pregnancy. For more information, see the “Mycapssa and pregnancy” section above.
  • Breastfeeding. It’s not known if Mycapssa can pass into human breast milk. For more information, see the “Mycapssa and breastfeeding” section above.

Note: For more information about the potential negative effects of Mycapssa, see the “Mycapssa side effects” section above.

Using more than the recommended dosage of Mycapssa can lead to serious side effects.

Do not use more Mycapssa than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Mycapssa from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Mycapssa comes in childproof packaging called a wallet. You should store unopened wallets in the refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). Opened wallets should be kept at a room temperature of 68°F to 77°F (20°C to 25°C). Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Mycapssa and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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