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       Growth Hormone Do's and Don't  (Things to know)
   DIR By: Road2HardCoreIron
       Date: March 9, 2023, 8:57 pm
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       Mayo Clinic
       Drugs and Supplements
       Growth Hormone (Parenteral Route)
       Description and Brand Names
       Drug information provided by: IBM Micromedex
       Descriptions
       Somatrem and somatropin are man-made versions of human growth
       hormone. Growth hormone is naturally produced by the pituitary
       gland and is necessary to stimulate growth in children. Man-made
       growth hormone may be used in children who have certain
       conditions that cause failure to grow normally. These conditions
       include growth hormone deficiency (inability to produce enough
       growth hormone), kidney disease, Prader-Willi Syndrome (PWS),
       and Turner's syndrome. Growth hormone is also used in adults to
       treat growth failure and to treat weight loss caused by acquired
       immunodeficiency syndrome (AIDS).
       This medicine is available only with your doctor's prescription.
       Before Using
       Allergies
       Tell your doctor if you have ever had any unusual or allergic
       reaction to medicines in this group or any other medicines. Also
       tell your health care professional if you have any other types
       of allergies, such as to foods dyes, preservatives, or animals.
       For non-prescription products, read the label or package
       ingredients carefully.
       Pediatric
       There is no specific information comparing use of growth hormone
       in children with acquired immunodeficiency syndrome (AIDS) with
       use in other age groups.
       Geriatric
       Many medicines have not been studied specifically in older
       people. Therefore, it may not be known whether they work exactly
       the same way they do in younger adults. Although there is no
       specific information comparing use of growth hormone in the
       elderly with use in other age groups, it is not expected to
       cause different side effects or problems in older people than it
       does in younger adults. However, elderly patients may be more
       sensitive to the action of growth hormone drugs and may be more
       at risk to develop adverse reactions.
       Pregnancy
       Growth hormone has not been studied in pregnant women. However,
       in animal studies, growth hormone has not been shown to cause
       birth defects or other problems. This drug should be used during
       pregnancy only if clearly needed. Tell your doctor if you are
       pregnant or plan on becoming pregnant.
       Breastfeeding
       It is not known whether growth hormone passes into breast milk.
       However, you should tell your doctor if you are nursing.
       Drug Interactions
       Although certain medicines should not be used together at all,
       in other cases two different medicines may be used together even
       if an interaction might occur. In these cases, your doctor may
       want to change the dose, or other precautions may be necessary.
       When you are taking any of these medicines, it is especially
       important that your healthcare professional know if you are
       taking any of the medicines listed below. The following
       interactions have been selected on the basis of their potential
       significance and are not necessarily all-inclusive.
       Using medicines in this class with any of the following
       medicines is usually not recommended, but may be required in
       some cases. If both medicines are prescribed together, your
       doctor may change the dose or how often you use one or both of
       the medicines.
       Balofloxacin
       Besifloxacin
       Bupropion
       Ciprofloxacin
       Enoxacin
       Fleroxacin
       Flumequine
       Gatifloxacin
       Gemifloxacin
       Levofloxacin
       Lomefloxacin
       Moxifloxacin
       Nadifloxacin
       Norfloxacin
       Ofloxacin
       Pazufloxacin
       Pefloxacin
       Prulifloxacin
       Rufloxacin
       Sparfloxacin
       Tosufloxacin
       Other Interactions
       Certain medicines should not be used at or around the time of
       eating food or eating certain types of food since interactions
       may occur. Using alcohol or tobacco with certain medicines may
       also cause interactions to occur. Discuss with your healthcare
       professional the use of your medicine with food, alcohol, or
       tobacco.
       Other Medical Problems
       The presence of other medical problems may affect the use of
       medicines in this class. Make sure you tell your doctor if you
       have any other medical problems, especially:
       Acute critical illnesses (e.g., complications following open
       heart or abdominal surgery, accidental trauma, or respiratory
       failure)—Growth hormone use has not been studied in patients
       with these serious illnesses. Your doctor will weigh the
       benefits and risks before starting you on this medicine.
       Brain tumor—Growth hormone should not be used in patients who
       have a brain tumor that is still growing.
       Diabetes mellitus (sugar diabetes) or a family history of
       diabetes mellitus—Growth hormone may prevent insulin from
       working as well as it should; your doctor may have to change
       your dose of insulin.
       Diabetic retinopathy (inflammation of the retina in diabetic
       patients)—Growth hormone should not be used in these patients.
       Prader-Willi syndrome [a rare genetic disorder]—Certain patients
       with this rare genetic disorder may be at increased risk for
       side effects from growth hormone therapy. You and your doctor
       will decide if growth hormone is right for you.
       Tumors—If you already have a tumor, your doctor should treat you
       for it before beginning this medicine. If the tumor comes back,
       growth hormone medicine should be stopped.
       Underactive thyroid—This condition can interfere with the
       effects of growth hormone.
       Proper Use
       Some medicines given by injection may sometimes be given at home
       to patients who do not need to be in the hospital. If you are
       using this medicine at home, your health care professional will
       teach you how to prepare and inject the medicine. You will have
       a chance to practice preparing and injecting it. Be certain that
       you understand exactly how the medicine is to be prepared and
       injected.
       It is important to read the patient information and instructions
       for use, if provided with your medicine, each time your
       prescription is filled.
       It is important to follow any instructions from your doctor
       about the careful selection and rotation of injection sites on
       your body. This will help to prevent skin problems.
       Put used needles and syringes in a puncture-resistant disposable
       container or dispose of them as directed by your health care
       professional. Do not reuse needles and syringes.
       Dosing
       The dose medicines in this class will be different for different
       patients. Follow your doctor's orders or the directions on the
       label. The following information includes only the average doses
       of these medicines. If your dose is different, do not change it
       unless your doctor tells you to do so.
       The amount of medicine that you take depends on the strength of
       the medicine. Also, the number of doses you take each day, the
       time allowed between doses, and the length of time you take the
       medicine depend on the medical problem for which you are using
       the medicine.
       For somatrem
       For injection dosage form:
       For treatment of growth failure caused by growth hormone
       deficiency:
       Children—Dose is based on body weight and must be determined by
       your doctor. The usual total weekly dose is 0.3 milligram (mg)
       per kilogram (kg) (0.136 mg per pound) of body weight. This is
       divided into smaller doses and usually is injected under the
       skin, but may be injected into a muscle as determined by your
       doctor.
       For somatropin
       For injection dosage form:
       For treatment of growth failure caused by growth hormone
       deficiency:
       Adults—Dose is based on body weight and must be determined by
       your doctor. At first, it is usually 0.005 milligram (mg) per
       kilogram (kg) (0.0023 mg per pound) of body weight injected
       under the skin once a day. Your doctor may then increase the
       dose if needed.
       Adults using Norditropin Cartridges or Norditropin
       NordiFlex—Dose is based on body weight and must be determined by
       your doctor. At first, it is usually 0.004 milligram (mg) per
       kilogram (kg) (0.0002 mg per pound) of body weight injected
       under the skin once a day. Your doctor may then increase the
       dose if needed. The dose is given using a NordiPen injection
       device for Norditropin cartridges and a prefilled pen for
       Norditropin NordiFlex.
       Children—Dose is based on body weight and must be determined by
       your doctor. The usual total weekly dose is 0.16 to 0.3 mg per
       kg (0.073 to 0.136 mg per pound) of body weight. This is divided
       into smaller doses and usually is injected under the skin, but
       may be injected into a muscle as determined by your doctor.
       Children using Norditropin Cartridges or Norditropin
       NordiFlex—Dose is based on body weight and must be determined by
       your doctor. The usual dose is 0.024 to 0.034 mg per kg (0.011
       to 0.015 mg per pound of body weight) injected under the skin,
       on 6 to 7 days a week. The dose is given using a NordiPen
       injection device for Norditropin cartridges and a prefilled pen
       for Norditropin NordiFlex.
       For treatment of growth failure caused by kidney disease:
       Children—Dose is based on body weight and must be determined by
       your doctor. The usual total weekly dose is 0.35 mg per kg (0.16
       mg per pound) of body weight. This is divided into smaller daily
       doses and is injected under the skin or into a muscle.
       For treatment of growth failure caused by Turner's syndrome:
       Children—Dose is based on body weight and must be determined by
       your doctor. The usual total weekly dose is 0.375 mg per kg
       (0.17 mg per pound) of body weight. This is divided into smaller
       doses and is injected under the skin.
       For treatment of growth failure caused by Prader-Willi syndrome:
       Children—Dose is based on body weight and must be determined by
       your doctor. The usual total weekly dose is 0.24 mg per kg (0.11
       mg per pound) of body weight. This is divided into 6 or 7
       smaller doses over the course of the week and is injected under
       the skin.
       For treatment of weight loss caused by acquired immunodeficiency
       disease (AIDS):
       Adults weighing more than 121 pounds (55 kg)—6 mg injected under
       the skin once a day at bedtime.
       Adults weighing 99 to 121 pounds (45 to 55 kg)—5 mg injected
       under the skin once a day at bedtime.
       Adults weighing 77 to 98 pounds (35 to 44 kg)—4 mg injected
       under the skin once a day at bedtime.
       Adults weighing less than 77 pounds (35 kg)—Dose is based on
       body weight and must be determined by your doctor. It is usually
       0.1 mg per kg (0.045 mg per pound) of body weight injected under
       the skin once a day at bedtime.
       Children—Use and dose must be determined by your doctor.
       Storage
       Keep out of the reach of children.
       Do not keep outdated medicine or medicine no longer needed.
       Store at temperature directed by your health care professional
       or the manufacturer.
       Precautions
       It is important that your doctor check your progress at regular
       visits.
       Side Effects
       Leukemia has been reported in a few patients after treatment
       with growth hormone. However, it is not definitely known whether
       the leukemia was caused by the growth hormone. Leukemia has also
       been reported in patients whose bodies do not make enough growth
       hormone and who have not yet been treated with man-made growth
       hormone. However, discuss this possible effect with your doctor.
       If growth hormone is given to children or adults with normal
       growth, who do not need growth hormone, serious unwanted effects
       may occur because levels in the body become too high. These
       effects include the development of diabetes; abnormal growth of
       bones and internal organs such as the heart, kidneys, and liver;
       atherosclerosis (hardening of the arteries); and hypertension
       (high blood pressure).
       Along with its needed effects, a medicine may cause some
       unwanted effects. Although not all of these side effects may
       occur, if they do occur they may need medical attention.
       Check with your doctor as soon as possible if any of the
       following side effects occur:
       More common
       Abnormal or decreased touch sensation
       blurred vision
       burning, crawling, itching, numbness, prickling, "pins and
       needles", or tingling feelings
       dizziness
       ear infection or other ear problems (in patients with Turner's
       syndrome)
       nervousness
       pounding in the ears
       severe headache
       slow or fast heartbeat
       Less common
       Chest pain
       Rare
       Abdominal pain or bloating
       changes in vision
       depression of skin at place of injection
       headache
       limp
       nausea and vomiting
       pain and swelling at place of injection
       pain in hip or knee
       skin rash or itching
       Some side effects may occur that usually do not need medical
       attention. These side effects may go away during treatment as
       your body adjusts to the medicine. Also, your health care
       professional may be able to tell you about ways to prevent or
       reduce some of these side effects. Check with your health care
       professional if any of the following side effects continue or
       are bothersome or if you have any questions about them:
       More common
       Back pain
       chills
       cough or cough producing mucus
       constipation
       depressed mood
       diarrhea
       difficulty in breathing
       difficulty in moving
       dizziness
       dry skin and hair
       ear congestion
       feeling cold
       fever
       general feeling of discomfort or illness
       hair loss
       hoarseness or husky voice
       loss of appetite
       loss of voice
       runny nose
       shivering
       shortness of breath
       sore throat
       slowed heartbeat
       sneezing
       stuffy nose
       sweating
       swollen joints
       tightness in chest
       trouble sleeping
       weight gain
       wheezing
       Less common or rare
       Carpal tunnel syndrome
       enlargement of breasts
       feeling sad or empty
       increased growth of birthmarks
       irritability
       joint pain
       loss of interest or pleasure
       muscle pain, cramps, or stiffness
       skeletal pain
       sleepiness
       swelling of hands, feet, or lower legs
       trouble concentrating
       unable to sleep
       unusual tiredness or weakness
       Other side effects not listed may also occur in some patients.
       If you notice any other effects, check with your healthcare
       professional.
       Call your doctor for medical advice about side effects. You may
       report side effects to the FDA at 1-800-FDA-1088.
       Portions of this document last updated: Feb. 01, 2023
       Original article:
  HTML https://www.mayoclinic.org/drugs-supplements/growth-hormone-parenteral-route/side-effects/DRG-20069416
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