Drug reference

Somatropin

GnRH Analogue · Growth Hormone Deficiency Therapy

Also known as ACCRETROPIN, GENOTROPIN, HUMATROPE, NORDITROPIN, NUTROPIN, OMNITROPE

GnRH AnalogueGrowth Hormone Deficiency Therapy

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Somatropin is a recombinant human growth hormone that matches the amino acid sequence of native human growth hormone. It acts as replacement therapy for patients with growth hormone deficiency. By binding to growth hormone receptors, it stimulates linear growth in children and regulates metabolism in both children and adults. Its administration aims to restore physiological levels and functions of endogenous growth hormone.

Indications

GH deficiency in childrenGH-deficient adultsShort stature due to GH deficiency in childrenTurner syndromeNoonan syndromePrader-Willi syndromeChronic renal insufficiencyChildren born small for gestational ageIdiopathic short statureGH deficiency in adultsAIDS-associated wastingMalabsorption associated with the short-bowel syndromePituitary dwarfismTurner’s syndromeChildren with renal failureAIDS-related wastingConstitutional short stature (only if epiphyses are open)Adult GH deficiency (to increase lean body mass, decrease body fat, improve energy and mentation)

Dosing

Adult: range of doses that are generally regarded as being suitable for adults. Complementary and alternative medicine Prescribing unlicensed medicines An increasing amount of information on complementary and alternative medicine is becoming available.…
Pediatric: Typically 25 to 50 μg/kg per day subcutaneously in the evening; higher daily doses (e.g., 50–67 μg/kg) are employed for patients with Noonan syndrome or Turner syndrome. Treatment is continued until the epiphyses are fused.
Renal adjustment: Can be used in children with renal failure

Pharmacokinetics

Duration

once-daily administration is sufficient

Half-life

20 minutes

Bioavailability

70%

Contraindications

Pediatric patients with closed epiphyses (for growth promotion)
Acute critical illness (due to complications after open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure)
Evidence of active malignancy
Proliferative retinopathy
Severe nonproliferative diabetic retinopathy
Prader-Willi syndrome (if severely obese or with severe respiratory impairment, due to observed sudden death)
Known hypersensitivity
Postoperative patients
Trauma patients
Cancer patients
Critically ill patients

Side effects

Common

Peripheral edema (adults, at initiation)Carpal tunnel syndrome (adults, at initiation)Arthralgias (adults, at initiation)Myalgias (adults, at initiation)Intracranial hypertension with papilledema, visual changes, headache, nausea, or vomiting (rarely in children)Slipped epiphyses (children)Scoliosis (children)Pain at injection siteLipodystrophyGlucose intoleranceHypothyroidism (due to unmasking of TSH deficiency)Salt and water retentionHand stiffnessMyalgiaHeadache

Serious

Increased incidence of type 2 diabetes mellitus
Precipitation of adrenal insufficiency
Rise in intracranial tension

Drug interactions

Estrogens

Moderate

Textbook

Women taking oral, but not transdermal, estrogen may require larger GH doses to achieve the target IGF-1 level.

A larger dose of somatropin is needed to maintain the same IGF-1 level.

Source: G&G 14e · p930

Glucocorticoids

Moderate

Textbook

May precipitate adrenal insufficiency in patients with occult secondary adrenal insufficiency or in patients receiving replacement doses of glucocorticoids.

The dose of glucocorticoids may need to be adjusted when GH therapy is initiated.

Source: G&G 14e · p930

Insulin

Moderate

Textbook

Decreased insulin sensitivity, potentially requiring adjustment of antidiabetic medication.

The dose of insulin and/or other hypoglycemic agents may need to be adjusted when GH therapy is initiated.

Source: G&G 14e · p930