Somatropin

A to Z Drug Facts

 Action Mimics actions of naturally occurring growth hormone to stimulate linear and skeletal growth; increases number and size of skeletal muscle cells; increases RBC mass and internal organ size; increases cellular protein synthesis; reduces body fat stores and lipid mobilization and increases plasma fatty acids.

 Indications Long-term treatment of children with growth failure caused by lack of adequate endogenous growth hormone secretion. Nutropin is used for treatment of children with growth failure associated with chronic renal insufficiency up to time of renal transplantation.

 Contraindications Closed epiphyses; evidence of tumor activity, or active neoplasm; intracranial lesion must be inactive and antitumor therapy complete prior to instituting therapy; sensitivity to benzyl alcohol (Nutropin diluent) glycerin or M-cresol (Humatrope diluent).

 Route/Dosage

Growth Hormone Inadequacy

CHILDREN: (Humatrope) IM/SC 0.06 mg/kg 3 times/wk. CHILDREN: (Nutropin) SC 0.03 mg/kg daily.

Chronic Insufficiency

CHILDREN: (Nutropin) SC 0.035 mg/kg daily.

 Interactions

Glucocorticoids: May inhibit growth promoting effects of somatropin.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Headache; weakness; recurrent growth of intracranial tumor. DERM: Rash; urticaria; pain; inflammation at injection site. GU: Glucosuria; hypercalciuria. META: Hypothyroidism; hyperglycemia. OTHER: Localized muscle pain; mild, transient edema; antibodies to growth hormone.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Concomitant glucocorticoid therapy: May inhibit growth-promoting effects. Hypothyroidism: May develop during therapy; monitor thyroid function. Insulin resistance: May be induced with therapy; monitor for glucose intolerance. Intracranial hypertension: Intracranial hypertension, with papilledema, visual changes, headache, nausea or vomiting has been reported in few patients. Intracranial lesion: Frequently examine patients with history of lesion. Slipped capital epiphysis: May be seen in children with advanced renal osteodystrophy; may be affected by growth hormone. Be alert to development of limp or complaints of hip or knee pain.

 Administration/Storage

• Reconstitute each 5 mg vial with 1 to 5 ml or each 10 mg vial with 1 to 10 ml of Bacteriostatic Water for Injection, USP (benzyl alcohol preserved) only.
• Store before and after administration in refrigerator. Use reconstituted drug within 14 days; refrigerate until used; avoid freezing.
• In patients with sensitivity to M-cresol, glycerin or benzyl alcohol reconstitute with Sterile Water for Injection; use reconstituted dose within 24 hrs; refrigerate until used; do not freeze; use only 1 dose per vial; discard unused portion.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Be aware that use of product with glucocorticoid therapy may inhibit growth-promoting effects.
• Examine patients with history of intracranial lesion frequently for evidence of recurrence or progression of lesion.
• Monitor thyroid function test results.
• Be aware that insulin resistance may develop and monitor for signs of glucose intolerance.
• Be alert for signs of acromegaly and report to physician.
• Assess for common side effects of headache, weakness, localized muscle pain or transient edema and report to physician.
• Report any limp or complaints of hip or knee pain in children to physician; this may indicate slipped epiphyses.

 Patient/Family Education

• Instruct diabetic patients to monitor blood sugar closely and to report variations to physician.
• Tell children and parents to report limp or complaints of hip or knee pain to physician as soon as possible.
• Instruct patient to report these symptoms to physician: headache, weakness, localized muscle pain or mild, transient edema.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts