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Somatropin, mammalian derived (Injection route, subcutaneous route)

Pronunciation:

soe-ma-TROE-pin, mam-MAY-lee-un dee-RIVED

Brand Names:

  • Saizen
  • Serostim
  • Zorbtive
  • Nutropin
  • Nutropin Aq

Dosage Forms:

  • Powder for Solution

Classifications:

Therapeutic—

Endocrine-Metabolic Agent

Pharmacologic—

Somatropin

Uses of This Medicine:

Somatropin injection is a man-made version 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 adults or children who have certain conditions that prevent normal growth. These conditions include growth failure caused by growth hormone deficiency (inability to produce enough growth hormone), chronic kidney disease, idiopathic short stature (unexplained shortness), or Turner syndrome.

Somatropin injection is also used together with a proper diet to treat short bowel syndrome (SBS), which is a condition that prevents the intestine or gut from absorbing food properly.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of somatropin injection in children with growth hormone deficiency.

Appropriate studies have not been performed on the relationship of age to the effects of somatropin injection in children with short bowel syndrome. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of somatropin injection in the elderly. However, elderly patients are more sensitive to the effects of somatropin, which may require an adjustment of dosage in patients receiving somatropin injection.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

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. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

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 this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Brain tumor or
  • Cancer, active or
  • Closed epiphyses (normal bone growth stopped) in children or
  • Diabetic retinopathy (eye condition) or
  • Prader-Willi syndrome (a genetic disorder), if severely overweight or have severe breathing problems or
  • Severe illness after surgery or major medical emergency (e.g., open heart surgery, abdominal surgery, accidental trauma, or respiratory failure)—Should not be used in patients with these conditions.
  • Cancer, history of or
  • Fluid retention, history of or
  • Hypopituitarism (pituitary gland produces low hormone levels) or
  • Hypothyroidism (underactive thyroid gland) or
  • Otitis media (ear infection) in children, history of or
  • Pancreatitis (inflammation or swelling of the pancreas) or
  • Scoliosis (abnormally curved spine)—Use with caution. May make these conditions worse.
  • Diabetes, or a family history of—Use with caution. May prevent insulin from working properly. .
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Turner syndrome—May increase risk of having thyroid and hearing problems.

Proper Use of This Medicine:

This medicine is given as a shot under your skin or into a muscle. Somatropin 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 doctor will teach you how to prepare and inject the medicine. Be sure that you understand exactly how the medicine is prepared and injected.

If you are using this medicine to treat short bowel syndrome, carefully follow your doctor's instructions about any special diet. Take all other medicines or supplements your doctor has prescribed as part of your combination treatment.

This medicine comes with a patient information insert. Read and follow the instructions in the insert carefully. Ask your doctor if you have any questions.

There are many different forms (e.g., vial, cartridge, injection device) available for this medicine. Make sure your doctor, nurse, or pharmacist instructs you on how to prepare and administer this medication. Also, read all instructions carefully to be sure you know how to use your device.

Each time you get your medicine, check to be sure you have received the proper device. Talk to your pharmacist if you have questions about the device that you were given.

You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the injections.

Use a new needle, unopened vial, or syringe each time you inject your medicine.

You might not use all of the medicine in each vial (glass container). Use each vial only one time. Do not save an open vial. If the medicine in the vial has changed color, or if you see particles in it, do not use it.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing—

The dose of this medicine 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 this medicine. 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 injection dosage form:
    • For treatment of growth hormone deficiency:
      • Adults—
        • Nutropin® or Nutropin AQ®:
          • Non-weight based: At first, the usual dose is 0.15 to 0.3 milligrams (mg) injected under the skin once a day. Your doctor may adjust your dose if needed.
          • Weight-based: Dose is based on body weight and must be determined by your doctor. At first, the usual dose is not more than 0.006 milligram (mg) per kilogram (kg) of body weight injected under the skin once a day. Your doctor may adjust your dose if needed. However, the dose is usually not more than 0.025 to 0.0125 mg per kg of body weight per day.
        • Saizen®: Dose is based on body weight and must be determined by your doctor. At first, the usual dose is not more than 0.005 mg per kg of body weight injected under the skin once a day. Your doctor may adjust your dose if needed.
      • Children—
        • Nutropin® or Nutropin AQ®: Dose is based on body weight and must be determined by your doctor. The weekly dose is up to 0.3 to 0.7 mg per kg of body weight injected under the skin and divided into daily doses. Your doctor may adjust your dose if needed.
        • Saizen®: Dose is based on body weight and must be determined by your doctor. The usual dose is 0.06 mg per kg of body weight, given three times per week and injected under the skin or into a muscle. Your doctor may adjust your dose if needed.
        .
    • For treatment of growth failure due to chronic kidney disease:
      • Children—Dose is based on body weight and must be determined by your doctor. The weekly dose is up to 0.35 milligram (mg) per kilogram (kg) of body weight injected under the skin and divided into daily doses. Your doctor may adjust your dose if needed.
    • For treatment of idiopathic short stature:
      • Children—Dose is based on body weight and must be determined by your doctor. The weekly dose is up to 0.3 milligram (mg) per kilogram (kg) of body weight injected under the skin and divided into daily doses. Your doctor may adjust your dose if needed.
    • For treatment of short bowel syndrome:
      • Adults—Dose is based on body weight and must be determined by your doctor. At first, the usual dose is 0.1 milligram (mg) per kilogram (kg) of body weight injected under the skin once a day for 4 weeks. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of short stature with Turner syndrome:
      • Children—Dose is based on body weight and must be determined by your doctor. The weekly dose is up to 0.375 milligram (mg) per kilogram (kg) of body weight injected under the skin and divided into equal doses 3 to 7 times per week. Your doctor may adjust your dose if needed.

Missed dose—

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

Storage—

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store unopened vials, cartridges, and injection devices of Nutropin® and Nutropin AQ® in the refrigerator, away from heat and direct light. Do not freeze.

Store unopened vials of Saizen® and Zorbtive® at room temperature, away from heat and direct light. Do not freeze.

Store the medicine that has been mixed in the refrigerator. The Nutropin® or Saizen® vials and Zorbtive® that has been mixed should be used within 14 days. The Saizen® click.easy® cartridge that has been mixed should be used within 21 days. Nutropin AQ® vial, cartridge, and injection device should be used within 28 days. Make sure you understand how long you can store the medicine after it has been mixed. Throw away any mixed medicine that has not been used within this time.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Precautions While Using This Medicine:

It is very important that your doctor check you or your child at regular visits for any problems or unwanted effects that may be caused by this medicine.

This medicine may cause a serious allergic reaction that requires immediate medical attention. Tell your doctor right away if you or your child have a rash, itching, swelling of the face, tongue, or throat, trouble with breathing, or chest pain after you get the injection.

This medicine may cause a dislocation in the hip bone, especially in patients with growth hormone deficiency or Turner syndrome. Check with your doctor right away if you or your child has a limp or pain in the hip or knee.

Pancreatitis (an inflamed pancreas) may occur while you are using this medicine. Check with your doctor right away if you or your child are having more than one of these symptoms: bloating, chills, constipation, darkened urine, fast heartbeat, fever, indigestion, loss of appetite, nausea, pains in stomach, side, or abdomen possibly radiating to the back, vomiting, or yellow eyes or skin.

This medicine may affect blood sugar levels. Check with your doctor if you or your child notice a change in the results of your blood or urine sugar tests or if you have any questions.

This medicine may cause an increased pressure in the head. Check with your doctor immediately if headache, nausea, vomiting, blurred vision, or any other change in vision occurs during treatment. Your doctor may want you or your child to have your eyes checked by an ophthalmologist (eye doctor).

This medicine may cause fluid retention (extra water in the body). Tell your doctor if you or your child have burning, numbness, pain, or tingling in all fingers except smallest finger; swelling of the hands and feet; or pain, swelling, or stiffness of the muscles. Your doctor may adjust your dose to reduce these side effects.

This medicine is usually mixed with Bacteriostatic Water for Injection. You should not use Bacteriostatic Water for Injection if you have had an allergic reaction to benzyl alcohol. If this is a concern, ask your doctor about other ways to mix this medicine.

Side Effects of This Medicine:

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 immediately if any of the following side effects occur:

More common
Abnormal or decreased touch sensation
bleeding after defecation
bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
bloating or swelling of the face, arms, hands, lower legs, or feet
blood in the urine
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
changes in skin color
cold flu-like symptoms
cold hands and feet
confusion
constipation
cough or hoarseness
darkened urine
decreased urination
diarrhea
difficult urination
dizziness
dry mouth
fainting or loss of consciousness
fast heartbeat
fast or irregular breathing
feeling unusually cold
fever or chills
full or bloated feeling
general feeling of discomfort or illness
headache
increase in heart rate
itching
joint pain
light-colored stools
lightheadedness
loss of appetite
lower back or side pain
muscle aching or cramping
muscle pain or stiffness
nausea
pain
pain, redness, or swelling in the arm or leg
pains in the stomach, side, or abdomen, possibly radiating to the back
pressure in the stomach
rapid, shallow breathing
rapid weight gain
rectal bleeding
runny nose
shivering
skin rash
sneezing
sore mouth or tongue
sore throat
stomach bloating, burning, cramping, or pain
sudden decrease in the amount of urine
sweating
swelling of the abdominal or stomach area
swelling of the eyes or eyelids
swelling or puffiness of the face
swollen joints
thirst
tightness in the chest and/or wheezing
tingling of the hands or feet
trouble with breathing
trouble with sleeping
uncomfortable swelling around the anus
unpleasant breath odor
unusual tiredness or weakness
unusual weight gain or loss
vomiting
vomiting of blood
white patches in the mouth, tongue, or throat
wrinkled skin
yellow eyes or skin
Less common
Bone or skeletal pain
burning, numbness, pain, or tingling in all fingers except smallest finger
chest pain
depressed mood
dry skin and hair
feeling cold
hair loss
hoarseness or husky voice
slowed heartbeat
swelling of the ankles

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of Overdose
Anxiety
blurred vision
changes in vision
cold sweats
coma
cool, pale skin
decrease in the amount of urine
depression
excessive sweating
extreme weakness
flushed, dry skin
frequent urination
fruit-like breath odor
increase in hands and feet size
increased hunger
increased thirst
increased urination
increased volume of pale, diluted urine
nightmares
noisy, rattling breathing
pain in the arms or legs
seizures
shakiness
shortness of breath
slurred speech
stop in menstruation
swelling of the fingers or hands
troubled breathing at rest

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
Body aches or pain
breast pain
change in the color, amount, or odor of vaginal discharge
congestion
discoloration of the fingernails or toenails
dryness or soreness of the throat
excess air or gas in the stomach or intestines
frequent urge to defecate
increased sweating
passing gas
rash
sneezing
straining while passing stool
stuffy nose
tender, swollen glands in neck
trouble with swallowing
voice changes
Less common
Discouragement
feeling sad or empty
irritability
lack of appetite
loss of interest or pleasure
sleeplessness
tiredness
trouble concentrating
unable to sleep

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.


Last Updated: 4/4/2014

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