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Indications for: HUMATROPE
Growth failure in children due to inadequate endogenous GH secretion. Children with short stature associated with Turner syndrome. Children with idiopathic short stature (ISS), height standard deviation score (SDS) <-2.25, and associated with growth rates unlikely to permit attainment of adult height in the normal range. Children with short stature homeobox-containing gene (SHOX) deficiency. Children with short stature born small for gestational age (SGA) with no catch-up growth by age 2–4yrs. Adults with GH deficiency, as replacement of endogenous GH. MORE ON HGH
Give by SC inj into back of upper arm, abdomen, buttock, or thigh; rotate inj sites. Individualize. Weight-based: initially 0.006mg/kg/day; may increase to max 0.0125mg/kg/day. Non-weight based: initiate at approx. 0.2mg/day (range: 0.15–0.3mg/day), may increase gradually every 1–2 months by increments of approx. 0.1–0.2mg/day. Elderly: consider using lower doses. Obesity: use non-weight based regimen.
Give by SC inj into back of upper arm, abdomen, buttock, or thigh; rotate inj sites. Weekly dose should be divided over 6 or 7 days. GH deficient: 0.18–0.3mg/kg/week. Turner syndrome: up to 0.375mg/kg/week. ISS: up to 0.37mg/kg/week. SHOX deficiency: 0.35mg/kg/week. SGA: up to 0.47mg/kg/week; see full labeling. Discontinue therapy for linear growth stimulation when the epiphyses are fused. RELATED PRODUCTS
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Increased mortality in those with acute critical illness (see Contraindications). PWS: evaluate baseline respiratory function; monitor weight and for respiratory infection; interrupt if signs of upper airway obstruction or sleep apnea occurs. Not for treatment of children with growth failure due to PWS. History of GHD secondary to intracranial neoplasm: monitor routinely for tumor progression or recurrence. Increased risk of malignancies; if preexisting, complete treatment prior to somatropin initiation; discontinue if there is evidence of recurrent activity. Monitor for increased growth or malignant changes of preexisting nevi. Diabetes. Obesity. Intracranial hypertension (esp. in Turner syndrome): perform routine funduscopic exam at baseline and periodically thereafter; discontinue if papilledema develops. Hypoadrenalism: monitor for reduced serum cortisol levels. Scoliosis (monitor). Hypothyroidism. Monitor thyroid function, glucose tolerance. May increase serum phosphorous, alkaline phosphatase, parathyroid hormone, IGF-1 after therapy. Elderly. Pregnancy. Nursing mothers.
Growth hormone (GH).
May require increase in maintenance or stress doses of glucocorticoids in hypoadrenalism. May be antagonized by non-replacement glucocorticoids; adjust glucocorticoid dose in children. Concomitant drugs metabolized by CYP450 enzymes; monitor. Antidiabetic medications may need to be adjusted. Women on oral estrogen: may need higher somatropin dose.
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