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Children and teenagers who don't make enough growth hormone on their own are said to have pediatric growth hormone deficiency, or PGHD. Doctors may prescribe Nutropin AQ^® [somatropin (rDNA origin) injection] or Nutropin^® [somatropin (rDNA origin) for injection] to treat PGHD.

How human growth hormone (hGH) works in your body

Made by the pituitary gland in the brain, hGH 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 PGHD happens

PGHD, though rare, can happen at any time during infancy or childhood. There are many possible causes. For example, damage to the pituitary gland (a small gland that secretes hormones that control other glands and regulate growth) or the hypothalamus (a part of the brain that controls the pituitary) may be involved.

How PGHD is diagnosed

A major sign of PGHD is a noticeable slowing of growth. Your healthcare team does a "clinical workup"—takes your medical history, gives a physical exam, takes measurements, and orders lab work—that may help eliminate other conditions and show if your body is making enough hGH.

How PGHD may be treated

Your doctor may prescribe growth hormone therapy to treat PGHD. For a child or teenager with PGHD, GH therapy means taking regular injections of growth hormone (such as Nutropin AQ or Nutropin) until the doctor determines that GH therapy should end.

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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