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As an adult, the idea of taking “growth” hormone seems unusual. After all, most people reach full height during their teens. As an adult facing Nutropin^® [somatropin (rDNA origin) for injection] therapy, it’s only natural that you have some questions. While you should always make it a point to discuss any concerns with your healthcare professional, here are answers to some of the basic questions about adult growth hormone deficiency and Nutropin and Nutropin therapy.

Click questions to see answers.

What is AGHD?

A: Adult growth hormone deficiency (AGHD) occurs when the pituitary gland does not secrete enough growth hormone. In adult patients, pituitary disease may occur as a result of pituitary tumors, pituitary surgery, radiation therapy, or head injury—impacting the gland’s ability to produce sufficient growth hormone.

Generally, adults with growth hormone deficiency can be divided into 2 groups: those who were growth hormone deficient as children and continue to be so as adults (childhood-onset patients) and adults with pituitary disease who became growth hormone deficient as adults (adult-onset patients).

I’ve finished growing—why do I need to take Nutropin?

A: Although growth hormone (GH) is vital for developmental growth, our bodies also continue to produce GH throughout our lives—even long after we have stopped growing. Scientists have discovered that adults who lack naturally occurring GH may experience many symptoms.

I am taking other hormone medications—why do I need to take Nutropin?

A: Depending on the cause of adult GHD, many people may need to take other hormones. The pituitary gland is actually responsible for releasing and controlling many hormones in our bodies. Each of these hormones is released into the bloodstream. Once in the blood, each hormone travels to a different part of the body to perform a specific function. GH released from the pituitary is important for growth in children. Other hormones released from the pituitary are important for other reasons—from salt and water regulation to helping our bodies deal with stress. GH cannot replace the function of these other hormones. Remember to tell your healthcare professional about all of the medications that you are taking, including nonprescription medications, vitamins, and supplements.

How is AGHD diagnosed?

A: Based on a smaller-than-normal response to a growth hormone stimulation test, your doctor diagnoses you with AGHD. Your healthcare professional may perform diagnostic tests if he or she feels you may be at risk for growth hormone deficiency. In order to be diagnosed with adult growth hormone deficiency you must meet either of the following two criteria:

If you have adult-onset growth hormone deficiency, you must have a deficiency of growth hormone either alone, or in combination with deficiencies in other hormones resulting from disease, surgery, radiation therapy, or trauma.

If your growth hormone deficiency began in childhood, the diagnosis of your childhood condition will need to be confirmed prior to beginning therapy as an adult.

What pituitary problems cause adult-onset growth hormone deficiency?

A: In adults, growth hormone deficiency may often result when the pituitary gland becomes diseased or damaged. Particular tumors of the pituitary gland (pituitary adenomas), physical injury to the brain (hemorrhage, trauma, surgery), or radiation therapy can all injure the pituitary gland severely enough to cause growth hormone deficiency.

In the US, approximately 50,000 adults have growth hormone deficiency and 6,000 new cases of AGHD are diagnosed each year. Children who receive growth hormone therapy may need to continue with the therapy into adulthood if AGHD is confirmed.

Why did my healthcare professional order a DEXA scan before I started taking Nutropin therapy?

A: Dual-energy X-ray absorptiometry (DEXA) is a special kind of X-ray that uses a very low amount of radiation. It is the method that healthcare professionals use to determine body composition or the proportion of your body that is made up of fat. DEXA is also considered the “gold standard” for measuring bone density. Patients with AGHD may experience changes in decreased bone density and body composition. By taking a DEXA scan before you begin treatment, your healthcare professional will have a baseline measurement of your bone density and the composition of your body.

Does a patient need to rotate their injection sites?

A: To avoid tissue atrophy that may result from subcutaneous administration of GH at the same site over a long period of time, the injection site should be rotated.

Can patients experience fluid retention while on GH therapy?

A: Fluid retention during GH replacement therapy in adults may occur. Clinical manifestations of fluid retention are usually transient and dose dependent.

You may report side effects to the FDA at 1-800-FDA-1088 or to Genentech Drug Safety/Adverse Events at 1-888-835-2555.

What are the side effects of Nutropin and Nutropin AQ?

A: 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.

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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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