Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

1. Saizen
2. Serostim
3. Zorbtive

Canadian Brand Name

1. Nutropin
2. Nutropin Aq

Descriptions

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.

This product is available in the following dosage forms:

• Powder for Solution

Before Using

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.

Pediatric

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.

Geriatric

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.

Breastfeeding

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.

Drug Interactions

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 (eg, 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

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 (eg, 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 3 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

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 serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth 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

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

1. Abnormal or decreased touch sensation
2. bleeding after defecation
3. 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
4. bloating or swelling of the face, arms, hands, lower legs, or feet
5. blood in the urine
6. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
7. changes in skin color
8. cold flu-like symptoms
9. cold hands and feet
10. confusion
11. constipation
12. cough or hoarseness
13. darkened urine
14. decreased urination
15. diarrhea
16. difficult urination
17. dizziness
18. dry mouth
19. fainting or loss of consciousness
20. fast heartbeat
21. fast or irregular breathing
22. feeling unusually cold
23. fever or chills
24. full or bloated feeling
25. general feeling of discomfort or illness
26. headache
27. increase in heart rate
28. itching or skin rash
29. joint pain
30. light-colored stools
31. lightheadedness
32. loss of appetite
33. lower back or side pain
34. muscle aching or cramping
35. muscle pain or stiffness
36. nausea
37. pain
38. pain, redness, or swelling in the arm or leg
39. pains in the stomach, side, or abdomen, possibly radiating to the back
40. pressure in the stomach
41. rapid, shallow breathing
42. rapid weight gain
43. rectal bleeding
44. runny nose
45. shivering
46. sneezing
47. sore mouth or tongue
48. sore throat
49. stomach bloating, burning, cramping, or pain
50. sudden decrease in the amount of urine
51. sweating
52. swelling of the abdominal or stomach area
53. swelling of the eyes or eyelids
54. swelling or puffiness of the face
55. swollen joints
56. thirst
57. tightness in the chest
58. tingling of the hands or feet
59. trouble breathing
60. trouble sleeping
61. uncomfortable swelling around the anus
62. unpleasant breath odor
63. unusual tiredness or weakness
64. unusual weight gain or loss
65. vomiting
66. vomiting of blood
67. white patches in the mouth, tongue, or throat
68. wrinkled skin
69. yellow eyes or skin

Less common

1. Bone or skeletal pain
2. burning, numbness, pain, or tingling in all fingers except smallest finger
3. chest pain
4. depressed mood
5. dry skin and hair
6. feeling cold
7. hair loss
8. hoarseness or husky voice
9. slowed heartbeat
10. swelling of the ankles

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

Symptoms of overdose

1. Anxiety
2. blurred vision
3. changes in vision
4. cold sweats
5. coma
6. cool, pale skin
7. decrease in the amount of urine
8. depression
9. excessive sweating
10. extreme weakness
11. flushed, dry skin
12. frequent urination
13. fruit-like breath odor
14. increase in hands and feet size
15. increased hunger
16. increased thirst
17. increased urination
18. increased volume of pale, diluted urine
19. nightmares
20. noisy, rattling breathing
21. pain in the arms or legs
22. seizures
23. shakiness
24. slurred speech
25. stop in menstruation
26. swelling of the fingers or hands
27. 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

1. Body aches or pain
2. breast pain
3. change in the color, amount, or odor of vaginal discharge
4. congestion
5. discoloration of the fingernails or toenails
6. dryness or soreness of the throat
7. excess air or gas in the stomach or intestines
8. frequent urge to defecate
9. increased sweating
10. passing gas
11. sneezing
12. straining while passing stool
13. stuffy nose
14. tender, swollen glands in neck
15. trouble with swallowing
16. voice changes

Less common

1. Discouragement
2. feeling sad or empty
3. irritability
4. lack of appetite
5. loss of interest or pleasure
6. tiredness
7. trouble concentrating

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.

Portions of this document last updated: Feb. 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/somatropin-mammalian-derived-injection-route-subcutaneous-route/side-effects/drg-20071668