Growth Hormones, Injection

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KEY POINTS

• This medicine is given by injection to treat growth hormone deficiency, treat wasting in people with AIDS, or help the bowel take in more water, electrolytes, and nutrients in people with short bowel syndrome. Use it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: growth hormone

Generic and brand names: growth hormones, injection; somatropin, injection; Genotropin; Genotropin Miniquick; Humatrope; Norditropin FlexPro; Nutropin AQ Pen; Nutropin AQ NuSpin; Omnitrope; Saizen; Serostim; Zomacton; Zorbtive

What is this medicine used for?

This medicine is given by injection (shots) to:

• Treat children with growth failure due to growth hormone deficiency, Prader-Willi syndrome, Turner syndrome, or other causes
• Treat a condition called wasting (loss of size and strength) in people with AIDS
• Help the bowel take in more water, electrolytes, and nutrients in people with short bowel syndrome
• Treat growth hormone deficiency in adults

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine or to benzyl alcohol or other preservatives
• Cancer or tumors, especially during childhood
• Carpal tunnel syndrome
• Diabetes
• Diabetic retinopathy (eye problems caused by diabetes)
• Ear infection or hearing disorder
• Heart problems or high blood pressure
• Kidney or liver problems
• Lung or breathing problems such as asthma, COPD, or sleep apnea
• Pancreas problems
• Pituitary or adrenal gland problems
• Problems with the growth plate in the leg
• Scoliosis
• Thyroid problems

Tell your healthcare provider if you have recently had a severe illness, surgery or injury. This medicine should not be given to a child with Prader-Willi syndrome who is also severely obese or has severe lung problems or sleep apnea. If you have Prader-Willi syndrome, this medicine must be used very carefully. Talk with your healthcare provider about this.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm the unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Your brand of this medicine, dose, and how often you will receive it depends on the condition you are being treated for. Follow your healthcare provider's instructions exactly. Do not use more or less or use it longer than prescribed. These shots are usually given into a muscle or just under the skin. You may be able to give yourself the shots, or have someone at home give them to you. Your provider will teach you how to use this medicine at home. Check the label on the medicine for directions about your specific dose. Be sure you understand when and how you are to receive your shots. Rotate the injection sites as directed by your healthcare provider. Ask your healthcare provider or pharmacist about anything you do not understand.

This medicine comes in the form of powder or in prefilled delivery devices. Make sure that you understand exactly how to give the shots. If your medicine must be mixed with a liquid, make sure you understand exactly how to mix the medicine. If you do not understand how to use the injection devices or disposable syringes, or how to mix the medicine, ask your healthcare provider or pharmacist to demonstrate. Use disposable syringes and needles only once and dispose of them safely, following your healthcare provider's instructions.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: swelling, headache, nausea, vomiting, hunger, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, fast heartbeat, fainting, increased thirst or urination, fruity breath, lightheadedness, seizures, coma.

What should I watch out for?

Your healthcare provider may want to see you regularly to check your progress. You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments.

This medicine may increase the risk of a second cancer if you have had cancer before, especially if you had radiation to the head. Talk with your healthcare provider about this.

Follow the diet and exercise program your healthcare provider recommends.

If you have Prader-Willi syndrome, it is very important to maintain a healthy body weight. If you start snoring, have increased snoring, have any changes in breathing during sleep, or develop a cold and coughing, contact your healthcare provider right away.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may increase the risk of developing diabetes, especially if you are overweight or have a family history of diabetes. If you already have diabetes, it may get worse. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Blurred vision or other vision changes; hip or knee pain; limping; confusion; increased urination; increased thirst or hunger; changes in skin moles; swelling of fingers, arms, feet, or legs; numbness or tingling in wrist, hands, or feet; sudden or severe back pain; severe muscle or joint pain or stiffness; sudden or severe stomach pain; yellowing of your skin or eyes; unexplained fever or cough; trouble breathing; unusual mood changes or depression; chest pain.

Other: Mild headache; pain, itching, or redness at the injection site; ear infection; trouble sleeping; mild nausea or stomach cramps; breast swelling or soreness; dizziness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Corticosteroids such as betamethasone, cortisone, dexamethasone, fludrocortisone, hydrocortisone (A-Hydrocort, Cortef), methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), prednisone (Prednisone Intensol), and triamcinolone (Aristospan, Kenalog)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Diabetes medicines such as glipizide (Glucotrol), glyburide (Glynase), insulin, metformin (Fortamet, Glucophage, Riomet), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• Estrogen hormones such as conjugated estrogens (Premarin) and estradiol (Climara, Estrace, Estraderm, Vivelle)
• Testosterone (Androderm, AndroGel, Axiron, Testim)
• Thyroid medicines such as levothyroxine (Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid), liothyronine (Cytomel, Triostat), liotrix (Thyrolar), and thyroid USP (Armour Thyroid, Nature-Throid)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store your medicine according to the instructions in your medicine package. How you store this medicine depends on the brand of medicine you are using.

The information that comes in your medicine package tells you how long you can use the medicine after it has been mixed or put in the pen injector. Do not let it freeze. Protect it from direct light. Ask your healthcare provider or pharmacist about anything you do not understand.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.