Some commonly used brand names are:

In the U.S.—

In Canada—

• Growth hormone --Somatrem; Somatropin

Somatrem and somatropin are man-made versions 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 children who have certain conditions that cause failure to grow normally. These conditions include growth hormone deficiency (inability to produce enough growth hormone), kidney disease, Prader-Willi Syndrome (PWS), and Turner's syndrome. Growth hormone is also used in adults to treat growth failure and to treat weight loss caused by acquired immunodeficiency syndrome (AIDS).

This medicine is available only with your doctor's prescription, in the following dosage forms:

Parenteral
• Somatrem
  • Injection (U.S. and Canada)
• Somatropin, Recombinant
  • Injection (U.S. and Canada)

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 growth hormone, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to growth hormone. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Growth hormone has not been studied in pregnant women. However, in animal studies, growth hormone has not been shown to cause birth defects or other problems.

Breast-feeding—It is not known whether growth hormone passes into breast milk.

Children—There is no specific information comparing use of growth hormone in children with acquired immunodeficiency syndrome (AIDS) with use in other age groups.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of growth hormone in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.

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. When you are taking growth hormone, it is especially important that your health care professional know if you are taking any of the following:

• Corticosteroids (cortisone-like medicines)—These medicines can interfere with the effects of growth hormone

• Brain tumor—Growth hormone should not be used in patients who have a brain tumor that is still growing
• Diabetes mellitus (sugar diabetes)—Growth hormone may prevent insulin from working as well as it should; your doctor may have to change your dose of insulin
• Underactive thyroid—This condition can interfere with the effects of growth hormone

Some medicines given by injection 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 health care professional will teach you how to prepare and inject the medicine. You will have a chance to practice preparing and injecting it. Be certain that you understand exactly how the medicine is to be prepared and injected.

It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body. This will help to prevent skin problems.

Put used needles and syringes in a puncture-resistant disposable container or dispose of them as directed by your health care professional. Do not reuse needles and syringes .

Dosing—

The dose of these medicines 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 these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

For somatrem
• For injection dosage form:
  • For treatment of growth failure caused by growth hormone deficiency:
    • Children—Dose is based on body weight and must be determined by your doctor. The usual total weekly dose is 0.3 milligram (mg) per kilogram (kg) (0.136 mg per pound) of body weight. This is divided into smaller doses and usually is injected under the skin, but may be injected into a muscle as determined by your doctor.

For somatropin
• For injection dosage form:
  • For treatment of growth failure caused by growth hormone deficiency:
    • Adults—Dose is based on body weight and must be determined by your doctor. At first, it is usually 0.006 milligram (mg) per kilogram (kg) (0.0027 mg per pound) of body weight injected under the skin once a day. Your doctor may then increase the dose if needed.
    • Children—Dose is based on body weight and must be determined by your doctor. The usual total weekly dose is 0.16 to 0.3 mg per kg (0.073 to 0.136 mg per pound) of body weight. This is divided into smaller doses and usually is injected under the skin, but may be injected into a muscle as determined by your doctor.
    • Children using Norditropin Cartridges—Dose is based on body weight and must be determined by your doctor. The usual dose is 0.024 to 0.034 mg per kg (0.011 to 0.015 mg per pound of body weight) injected under the skin, on 6 to 7 days a week. The dose is given using a Nordipen™ injection device.
  • For treatment of growth failure caused by kidney disease:
    • Children—Dose is based on body weight and must be determined by your doctor. The usual total weekly dose is 0.35 mg per kg (0.16 mg per pound) of body weight. This is divided into smaller daily doses and is injected under the skin or into a muscle.
  • For treatment of growth failure caused by Turner's syndrome:
    • Children—Dose is based on body weight and must be determined by your doctor. The usual total weekly dose is 0.375 mg per kg (0.17 mg per pound) of body weight. This is divided into smaller doses and is injected under the skin.
  • For treatment of growth failure caused by Prader-Willi syndrome:
    • Children—Dose is based on body weight and must be determined by your doctor. The usual total weekly dose is 0.24 mg per kg (0.11 mg per pound) of body weight. This is divided into 6 or 7 smaller doses over the course of the week and is injected under the skin.
  • For treatment of weight loss caused by acquired immunodeficiency disease (AIDS):
    • Adults weighing more than 121 pounds (55 kg)—6 mg injected under the skin once a day at bedtime.
    • Adults weighing 99 to 121 pounds (45 to 55 kg)—5 mg injected under the skin once a day at bedtime.
    • Adults weighing 77 to 98 pounds (35 to 44 kg)—4 mg injected under the skin once a day at bedtime.
    • Adults weighing less than 77 pounds (35 kg)—Dose is based on body weight and must be determined by your doctor. It is usually 0.1 mg per kg (0.045 mg per pound) of body weight injected under the skin once a day at bedtime.
    • Children—Use and dose must be determined by your doctor.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Store at temperature directed by your health care professional or the manufacturer.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

It is important that your doctor check your progress at regular visits.

Leukemia has been reported in a few patients after treatment with growth hormone. However, it is not definitely known whether the leukemia was caused by the growth hormone. Leukemia has also been reported in patients whose bodies do not make enough growth hormone and who have not yet been treated with man-made growth hormone. However, discuss this possible effect with your doctor.

If growth hormone is given to children or adults with normal growth, who do not need growth hormone, serious unwanted effects may occur because levels in the body become too high. These effects include the development of diabetes; abnormal growth of bones and internal organs such as the heart, kidneys, and liver; atherosclerosis (hardening of the arteries); and hypertension (high blood pressure).

• 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 as soon as possible if any of the following side effects occur:

  • More common
    • Ear infection or other ear problems (in patients with Turner's syndrome) 
    
    
  • Rare
    • Abdominal pain or bloating;  changes in vision;  depression of skin at place of injection ;  headache;  limp;  nausea and vomiting;  pain and swelling at place of injection;  pain in hip or knee;  skin rash or itching 
    
    

  Other 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. However, check with your doctor if any of the following side effects continue or are bothersome:

  • Less common or rare
    • Carpal tunnel syndrome;  enlargement of breasts;  increased growth of birthmarks;  joint pain;  muscle pain;  swelling of hands, feet, or lower legs;  unusual tiredness or weakness 
    
    

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.