Somatropin, E-Coli Derived

Somatropin is a synthetic human growth hormone that is used to treat conditions that cause growth hormone deficiency in both adults and children.

Overview

Also known by a number of brand names including Accretropin, Genotropin and Humatrope, somatropin is an artificially made version of a human growth hormone. It is used in patients of any age and treats conditions that inhibit the production of growth hormone, or in patients who are unable to produce enough growth hormone. As well as effectively treating bone fractures, bleeding ulcers and burns, it is used to treat hypopituitary dwarfism and idiopathic short stature. Additionally, it is effective in treating conditions that cause growth hormone deficiency (GHD) such as chronic kidney disease, Noonan syndrome and Turner syndrome.

Human growth hormone is vital for linear growth. Produced naturally in the pituitary gland, it prompts growth in children and teenagers and contributes to the regulation of our body composition. By stimulating amino acid uptake and protein synthesis in muscles and tissues, it has a significant impact on muscle and bone growth, sugar and fat metabolism, body fluids and potentially, heart function.

For those who aren’t producing enough growth hormone, they may notice a number of symptoms that are dependant on the source of their deficiency. It’s more common to see growth hormone deficiency (GHD) in children, with some having had it from birth (congenital growth hormone deficiency), yet it can also occur in adults and the elderly.

In children, GHD can be noticed by short height, younger, rounder faces than their peers and fat around the abdomen but normal proportions everywhere else. Puberty and development are also likely to be delayed. In older patients, GHD is usually the result of a brain injury or tumor that causes the pituitary gland to stop producing enough growth hormone. For both children and adults, GHD can cause problems with depression, memory and concentration as well as high levels of fat in the blood and high cholesterol. Reduced bone strength and frequent fractures or breaks are also common in those who have GHD.

Somatropin effectively replicates the growth hormones that the body’s pituitary gland produces, helping to restore growth in children as well as treat any GHD conditions. It should only ever be prescribed by a doctor as part of a treatment plan and is administered by injection or injection under the skin in solution or powder for solution form.

Conditions treated

  • Growth hormone deficiency
  • Chronic kidney disease
  • Idiopathic short stature
  • Noonan syndrome
  • Turner syndrome
  • Short stature homeobox-containing gene deficiency
  • Fractures
  • Broken bones
  • Burns
  • Bleeding ulcers
  • Hypopituitary dwarfism

Type of medicine

  • Synthetic growth hormone.

Side effects

As with all medication, somatropin has the potential to cause a number of unwanted side effects. Many patients may not experience any, however, it is important to keep track of any reactions that you may be experiencing. Large, flat, blue or purple patches in the skin and unusually warm skin are both common side effects that do not need medical attention whilst less common reactions that don’t need medical attention include the increased growth of skin lesions and swelling of the breasts or soreness of the breasts in both sexes. These reactions should go away once your body adjusts to the treatment, however, if they remain persistent or worsen, make sure to seek medical advice.

More common reactions that need medical attention include bleeding gums, bloating or swelling or the face, arms, hands, ankles or feet, coughing up blood and nosebleeds. Any burning, numbness, pain or tingling in all fingers but the smallest finger can also be a sign of a more serious reaction that should be treated as soon as possible. If you experience any prolonged bleeding, increased menstrual flow or vaginal bleeding, red or dark brown stools or urine and pain, redness and swelling in the joints, it is also important to see a doctor. Additionally, any abnormal weight gain, weight loss or rapid weight gain can be signs of adverse reactions to Somatropin. If you experience any of the above, make sure to contact your healthcare professional when possible.

Allergic reactions to medication are rare, however, they can be life-threatening and usually require immediate treatment. If you notice any rashes, itching or hives, swelling of the face or hands, chest tightness and any difficulty with breathing, make sure to alert a family member or anyone who you may live with and go to a hospital as soon as possible.

As with allergic reactions, it is also important to be aware of the signs of an overdose. These include a backache, excessive sweating, extreme weakness, the increased in the size of your hands and feet, more urine which is pale and diluted, extreme pain and the stop of menstruation. If you are concerned that you are experiencing any signs of an overdose, get medical help immediately.

Some side effects of somatropin can be signs of rare and serious reactions that will need medical intervention as soon as possible. If you experience blurred vision, bone pain, a change in personality, chills, confusion and a headache you must seek medical advice immediately. Changes in vision, fruit-like breath odor and the change in the ability to see colours, in particular, blue or yellow are also indicators of serious adverse reactions to Somatropin. In addition to this, increased hunger and thirst or the loss of appetite, nausea and lower flank and abdomen pain should all be flagged to a doctor when possible. Any yellowing of the skin or eyes, unusual fatigue or weakness, dark urine and vomiting can all be signs of jaundice and should be treated immediately. If you notice any warmth or pain at the injection site, the sensation of burning or a feeling of pressure and soreness or a rash, please alert your healthcare professional. These are signs of a reaction from the administration of somatropin and could result in severe illness. Finally, a curved spine, dry mouth, fast heartbeat, fever, limp pain in the hip or knee, difficulty in walking or talking, the loss of consciousness, seizures or a tumor are all serious and rare reactions that require medical treatment as soon as possible.

If you notice any side effects or worrisome changes to your health after starting your somatropin treatment, it is important that you discuss it with your doctor as soon as possible. Not all side effects have been listed above, so it is important that you read any medicine documentation thoroughly before beginning your treatment.

Dosage

The dose for somatropin is entirely dependant on your condition and will vary from person to person. It is important that your doctor has determined you dose and treatment plan. Before beginning your treatment, your doctor or nurse will show you how to administer the medication safely at home. You must always remember to use a new needle and syringe each time you inject somatropin.

The usual dose for adults who have growth hormone deficiency can be determined by a weight based regimen or a non-weight based one. For a weight-based regimen, the initial dose should be no more than 0.004 mg/kg administered subcutaneously once a day or a total of 0.04mg/kg per week in divided doses. The maximum dose should be 0.016 mg/kg per day or 0.08mg/kg per week in divided doses. Weekly doses should be split over six or seven days of subcutaneous injections. A non-weight regimen would consist of 0.2 mg administered subcutaneously once a day, with a range of 0.15 to 0.3mg.

With both weight and non-weight based regimes, the dose can be increased at four to eight-week intervals, by increments of 0.1 to 0.2mg per day, this should be based in the clinical response and serum IGF--I concentrations. The maintenance dosages can vary greatly between male and female patients and to reach the treatment goal, estrogen-replete women are likely to require higher doses than men.

For children with growth hormone deficiency, the usual dose should be 0.024 to 0.034mg/kg of somatropin administered subcutaneously once a day, six to seven times a week. Generally, a dose of 0.16 to 0.3mg/kg is advised for paediatric patients receiving treatment for GHD, but if the patient is pubertal, a weekly dosage of up to 0.7mg/kg may be used. For child patients receiving treatment for Prader-Willi syndrome, this dose should be a maximum of 0.24 mg/kk per week, split over six or seven days of subcutaneous injections. The most common dose for children with PWS is 0.16 to 0.24 mg/kg each week.

The dosage plan that a doctor will decide for a child will be reflective of their individual growth response. This response to therapy is known to decrease with time, however, the inability to increase the height rate, especially during the first year of treatment, will trigger close assessment and compliance of other causes of inadequate growth. Reasons for poor growth can include hypothyroidism, poor-nutrition and advanced bone age. In some cases, a doctor will use a serum insulin-like growth factor I levels, as these can be useful during dose titration.

A patient’s dose and administration plan can greatly differ from the above depending on the condition that will be treated. For example, children undergoing dialysis and with chronic renal disease should administer somatropin at bedtime, just before going to sleep or at least three to four hours after hemodialysis to prevent hematoma formation. Because of this, it is important that you discuss your treatment plan and dosage in depth with your doctor, before beginning your course of somatropin.

Interactions

There are a number of medications that can have negative interactions with somatropin, with 224 of them causing moderate interactions. It is particularly important to let your doctor know if you are taking any forms of bexarotene or levomethadyl acetate, as these can both cause major interactions with somatropin and your treatment.

The most common medicines to interact with somatropin include:

  • Adderall (amphetamine / dextroamphetamine)
  • Cymbalta (duloxetine)
  • Depo-Testosterone (testosterone)
  • Glyceryl T (guaifenesin / theophylline)
  • Normal Saline Flush (sodium chloride)
  • OxyContin (oxycodone)
  • Prevacid (lansoprazole)
  • Soma (carisoprodol)
  • Synthroid (levothyroxine)
  • Tegretol (carbamazepine)
  • Valium (diazepam)
  • Xanax (alprazolam)
  • Zofran (ondansetron)
  • Zyrtec (cetirizine)

As somatropin has the potential to react to so many medications, it is vital that your doctor knows of any prescription or over the counter medications that you may be taking in advance to your treatment. It is also essential that you include any herbal remedies, supplements or vitamins when discussing this with your doctor. Omega 3, multivitamins such as B complex 100 and Vitamin D3 are all of particular importance to your doctor as they can cause adverse interactions and affect your treatment.

Warnings

Before taking this medication, it is vital that your doctor is aware of any health problems that you may currently have. Active malignancy, acute critical illness, diabetic retinopathy and Prader-Willi syndrome are all of extreme importance to your doctor as they can have major reactions with somatropin. Diabetes, hypothyroidism, intracranial hypertension and scoliosis are also conditions which can have serious implications with somatropin. It is likely that your doctor will already be familiar with your medical history, however by letting them know your full medical history, you can help to avoid any serious interactions and side effects, as well as receive the most effective treatment possible.

Diet and lifestyle may also come into consideration before taking this medication, as certain foods and drinks can exacerbate side effects or negative reactions. Obese patients have a much higher chance of experiencing adverse effects and may require a different dosage or treatment plan.

Side effects should be closely monitored when taking somatropin due to the medication’s potential to cause some serious reactions. Alongside the possibility of affecting blood sugar levels and fluid retention, it can have severe implications to health including increased pressure in the head and pancreatitis. For patients with GHD or Turner syndrome, there is also a chance that it may cause a dislocation in the hipbone. If you notice a limp pain in the hip or knee in yourself or your child, contact your doctor right away. Even though severe reactions are very rare, it is important that you understand and are aware of the side effects that somatropin may cause before beginning your treatment.

In addition to this, it is important to be aware that using somatropin can increase your risk of getting cancer. Your doctor will only prescribe this medication if they deem the benefits to outweigh the risks, but if you are concerned about its effects at all, make sure to discuss it with your doctor.

Storage

Make sure to keep this medication out of the reach of children, vulnerable adults and pets. You should store it in away from direct sunlight, in a secure location in the refrigerator. Make sure that you do not freeze or shake somatropin as it can cause damage to the medication.

Before taking this medication, you will be shown how to dispose of needles, syringes and unused medication by a healthcare professional. Make sure that you understand and are comfortable with the instructions before beginning your treatment, but please discuss any extra concerns with your doctor. Always throw away used needles in a hard, closed container that they cannot break through and always throw away open vials or syringes. If the medicine in the vial has changed colour or you can see particles, please dispose of it as soon as possible.

As with all medication, you should dispose of somatropin if it has reached its label expiry date.

Summary

Effective treatment of somatropin can hugely benefit a person’s life, helping them to heal broken bones and make full recoveries from certain conditions. It is especially beneficial to children and adolescents who are human growth hormone deficient, helping them to develop properly and become less predisposed to becoming injured through broken or fractured bones. By replicating the natural growth hormone that our body produces in the pituitary gland, somatropin is successful in stimulating growth, contributing to lower blood fats and cholesterol, as well as speeding up the development of adolescents and children.

Symptoms of human growth hormone deficiency can be unpleasant, severely affecting children’s lives and self-esteem as well as causing depression, high blood fat and high cholesterol in all ages. In adults, human growth hormone deficiency tends to be the result of a condition that inhibits human growth hormone such as chronic kidney disease, or the result of head trauma or brain injury.

Administering somatropin can be a daunting prospect to some as it must be injected, usually subcutaneously. For those who are either self-administering or administering somatropin to children, this requires a lot of commitment and responsibility. Your healthcare professional will give you clear instructions and demonstrate exactly how you should administer somatropin before you start your treatment. You will also be shown the body areas where somatropin can be injected. It is important to remember to use a different body area each time you give yourself a shot, as well as keep track of each area so that you can rotate where you deliver your injection. For those who are particularly nervous or may still be unsure as to how to administer it, it is vital that you discuss it with your doctor.

This medication requires understanding and confidence when administering. You must take the exact dose that you have been instructed and ensure that you have a regular, stable routine of dosing. Your doctor will be happy to discuss any anxieties or questions that you may have regarding the dosage or administration of somatropin.

Somatropin has the possibility to cause unpleasant side effects that may be bothersome or uncomfortable. While some reactions are harmless to most will disappear once the body adjusts to the medicine, it is important to keep track of any side effects you may have and report them to the doctor is they cause concern. If you experience any bloating or swelling of the face, hands, ankles or feet and tingling or pain in all the fingers except for the smallest one, this could be a sign of fluid retention and should be treated by a doctor when possible. Make sure to read all the medical documentation that you receive with your medicine and make sure that your close family or co-inhabitants are aware of the medication that you are taking.

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017
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