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When a child or a teenager is growing poorly, but his or her body appears to be making normal amounts of growth hormone, he or she is said to have idiopathic short stature.

• “Idiopathic” means the cause is unknown
• “Short stature” means your child or teenager is markedly shorter than others of his or her age and gender

Children and teenagers with ISS do not have hGH deficiencies.

Children with Idiopathic Short Stature (ISS) have:

• Heights greater than or equal to 2.25 “standard deviations” below average for their age and sex, which puts them among the shortest 1.2% of children. (A standard deviation is used to measure the distance from the average in a group)
• Growth rates that indicate a low chance of reaching a normal adult height

Doctors may prescribe Nutropin AQ^® [somatropin (rDNA origin) injection] and Nutropin^® [somatropin (rDNA origin) for injection] to treat ISS and help your child grow.

How human growth hormone (hGH) works in your body

Made by the pituitary gland in the brain, growth hormone helps the body produce muscle and break down fats. It also plays a critical role in helping young bodies grow and develop.

When levels of growth hormone are too low, there’s an impact on many things the body does—including development and growth.

How ISS is diagnosed

ISS (also called non-growth hormone-deficient short stature) is typically diagnosed in two stages:

• First, your child or teenager is found to have a height in the lowest 1.2% of all US children of the same age and sex, with growth rates that indicate a low chance of reaching a normal adult height
• Second, other conditions that might slow growth, such as Turner Syndrome, chronic illness, or chronic renal insufficiency, are ruled out

How ISS may be treated

For children and teenagers who:

• Are not likely to grow to their potential adult height, as determined by a doctor
• Have bones that are still able to grow

ISS may be treated with growth hormone therapy.

If you have ISS, GH therapy means taking regular injections of growth hormone (such as Nutropin) until you reach your growth potential (as determined by your doctor), until the growing ends of your bones fuse, or as your doctor recommends.

IMPORTANT SAFETY INFORMATION

Nutropin and your safety:
Please read this important safety information carefully. Then, if you have any questions, talk with your doctor.

Nutropin is NOT for:

• Children and teenagers whose bones have finished growing
• Patients who have certain types of eye disease caused by diabetes
• Patients who have active cancer or any brain tumors
• Patients who are critically ill after open heart surgery or abdominal (stomach) surgery, are severely hurt, or have severe breathing problems
• Children and teenagers who have Prader-Willi syndrome and are very overweight or have trouble breathing
• Patients with a known sensitivity to benzyl alcohol, an ingredient in the liquid used to mix Nutropin Injection. Sterile water should be used when mixing Nutropin for newborns.

If any of these apply, talk to your doctor before you start taking Nutropin.

If you are about to start taking Nutropin, or are already taking it, be sure to tell the doctor who prescribed it:

• About ALL of the medications you are taking, including supplements
• If you have or develop a brain tumor
• If you are given any new medication, especially glucocorticoid steroids like hydrocortisone or prednisone
• If you are pregnant or if you become pregnant
• About ANY other condition or illness you have or develop

What are the possible side effects of Nutropin?
You may experience discomfort, soreness, or redness where Nutropin is injected.

Contact your doctor immediately if you experience:

• Ongoing injection site discomfort
• Curvature of the spine (scoliosis)
• Joint pain
• Puffy hands and/or feet (caused by fluid retention)
• Changes in vision, a bad headache, or nausea with or without vomiting
• Hip or knee pain
• A need to limp when you walk
• Pain in wrist (carpal tunnel)
• Allergic reaction

Be sure to inject Nutropin at a different recommended place on your body each time. Your doctor or nurse should supervise the first injection and provide training and instruction.

Your doctor is your primary source of information about your treatment.

Please see the full Prescribing Information for Nutropin and Nutropin AQ, available from your pharmacy and at www.nutropin.com, for more about Nutropin and safety.

Questions? Call the Nurse Hotline at 1-866-NUTROPIN (1-866-688-7674).

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