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 0.005 milligram (mg) per kilogram (kg) (0.0023 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.

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 (especially benzyl alcohol), 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. This drug should be used during pregnancy only if clearly needed. Tell your doctor if you are pregnant or plan on becoming pregnant.

Breast-feeding It is not known whether growth hormone passes into breast milk. However, you should tell your doctor if you are nursing.

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. However, elderly patients may be more sensitive to the action of growth hormone drugs and may be more at risk to develop adverse reactions.

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

• Acute critical illnesses (e.g., complications following open heart or abdominal surgery, accidental trauma, or respiratory failure) Growth hormone use has not been studied in patients with these serious illnesses. Your doctor will weigh the benefits and risks before starting you on this medicine.
• Brain tumor Growth hormone should not be used in patients who have a brain tumor that is still growing
• Diabetes mellitus (sugar diabetes) or a family history of diabetes mellitus Growth hormone may prevent insulin from working as well as it should; your doctor may have to change your dose of insulin
• Diabetic retinopathy (inflammation of the retina in diabetic patients) Growth hormone should not be used in these patients.
• Prader-Willi syndrome [a rare genetic disorder] Certain patients with this rare genetic disorder may be at increased risk for side effects from growth hormone therapy. You and your doctor will decide if growth hormone is right for you.
• Tumors If you already have a tumor, your doctor should treat you for it before beginning this medicine. If the tumor comes back, growth hormone medicine should be stopped.
• Underactive thyroid This condition can interfere with the effects of growth hormone