Genotropin, Miniquick, Humatrope, Norditropin, Nutropin, Nutropin AQ, Omnitrope, Serostim, Serostim LQ, Saizen, Zorbtive
Classifications: hormone; growth hormone; Therapeutic: growth hormone
Pregnancy Category: B, C (brand dependent)
1.5 mg, 4 mg, 5 mg, 5.8 mg, 6 mg, 8 mg, 10 mg injection
5 mg/1.5 mL, 15 mg/1.5 mL prefilled syringe
New recombinant growth hormone with the natural sequence of 191 amino acids characteristic of endogenous growth hormone
Induces growth responses similar to those produced in children treated with GH obtained from human pituitary glands.
Growth failure due to GH deficiency; replacement therapy prior to epiphyseal closure in patients with idiopathic GH deficiency;
GH deficiency secondary to intracranial tumors or panhypopituitarism; inadequate GH secretion; short stature in girls with
Turner's syndrome; AIDS wasting syndrome; short bowel syndrome.
Patient with closed epiphyses; underlying progressive intracranial tumor, cresol hypersensitivity, glycerin hypersensitivity;
diabetic retinopathy; respiratory insufficiency; during chemotherapy, radiation therapy, active neoplastic disease; Prader-Willi
syndrome; untreated hypothyroidism, obesity; pregnancy (category B or category C depending on the brand).
Diabetes mellitus or family history of the disease; history of upper airway obstruction, sleep apnea, or unidentified URI;
lactation; concomitant or prior use of thyroid or androgens in prepubertal male; hypothyroidism; surgery, trauma; neonates
with benzyl alcohol hypersensitivity; neonates; lactation.
Route & Dosage
Note: Dosing will vary with specific products Growth Hormone Deficiency
Adult: SC Humatrope 0.006 mg/kg (0.018 IU/kg) q.d., may increase [max: 0.0125 mg/kg/d (0.0375 IU/kg/d)]; Nutropin, Nutropin AQ 0.006 mg/kg q.d. (max: <35 y, 0.025 mg/kg/d; >35 y, 0.0125 mg/kg/d)
Child: SC Genotropin 0.160.24 mg/kg/wk divided into 67 q.d. doses; Humatrope 0.18 mg/kg/wk (0.54 IU/kg/wk) divided into equal doses given on either 3 alternate days or 6 times/wk; Norditropin 0.0240.034 mg/kg/d 67 times/wk; Nutropin, Nutropin AQ 0.3 mg/kg/wk (0.9 IU/kg/wk) divided into 67 q.d. doses
Inadequate Growth Hormone Secretion
Child: SC Nutropin 0.3 mg/kg every week
AIDS Wasting or Cachexia
Adult: SC Serostim >55 kg, 6 mg qh.s.; 4555 kg, 5 mg qh.s.; 3545 kg, 4 mg qh.s.; <35 kg, 0.1 mg/kg qh.s.
Short Bowel Syndrome
Adult: SC Zorbtive 0.1 mg/kg once daily for 4 wk (max: 8 mg/d)
- Reconstitute each brand following its manufacturer's instructions (vary from brand to brand).
- Read and carefully follow directions for use supplied with the Nutropin AQ PenTM Cartridge if this
is the product being used.
- Rotate injection sites; abdomen and thighs are preferred sites. Do not use buttocks until the child has been walking for
a year or more and the muscle is adequately developed.
- Store lyophilized powder at 2°8° C (36°46° F). After reconstitution, most preparations are
stable for at least 14 d under refrigeration. DO NOT FREEZE.
Adverse Effects (≥1%)Body as a Whole:
Pain, swelling at injection site; myalgia. Fatalities reported in patients with Prader-Willi syndrome and one or more of
, history of respiratory impairment or sleep apnea, or unidentified respiratory infection, especially male
patients. Metabolic: Hypercalciuria;
over saturation of bile with cholesterol, hyperglycemia, ketosis. Endocrine:
High circulating GH antibodies with resulting treatment failure, accelerated growth of intracranial tumor.
InteractionsDrug: anabolic steroids
, thyroid hormone, androgens
may accelerate epiphyseal closure; ACTH, corticosteroids
may inhibit growth response to somatropin.
In liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Assess bone age annually in all patients and especially those also receiving concurrent thyroid or androgen treatment, since
these drugs may precipitate early epiphyseal closure. Urge parent to take child for bone age assessment on appointed annual
- Lab test: Periodic serum and urine calcium and plasma glucose.
- Hypercalciuria, a frequent adverse effect in the first 23 mo of therapy, may be symptomless; however, it may be accompanied
by renal calculi, with these reportable symptoms: flank pain and colic, GI symptoms, urinary frequency, chills, fever, hematuria.
- Test for circulating GH antibodies (antisomatropin antibodies) in patients who respond initially but later fail to respond
- Observe diabetics or those with family history of diabetes closely. Obtain regular urine for glycosuria or fasting blood
glucose and HbA1C.
- Examine patients with GH deficiency secondary to intracranial lesion frequently for progression or recurrence of underlying
Patient & Family Education
- Be aware that during first 6 mo of successful treatment, linear growth rates may be increased 816 cm or more per year
(average about 7 cm/y or approximately 3 in.). Additionally, SC fat diminishes but returns to pretreatment value later.
- Record accurate height measurements at regular intervals and report to physician if rate is less than expected.
- In general, growth response to somatropin is inversely proportional to duration of treatment.
- Discontinue treatment when patient has reached satisfactory adult height, when epiphyses have fused, or when patient fails
to exhibit growth response.