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If you or your child has been diagnosed with growth hormone (GH) deficiency or a condition that requires GH therapy, you probably have many questions about Nutropin^® [somatropin (rDNA origin) for injection] therapy. While you should always make it a point to discuss any concerns with your healthcare professional, you may find the following questions and answers about GH and Nutropin a valuable starting point to your research. Simply choose a topic:

• GH and GH therapy
• Nutropin AQ^® NuSpin™
• Nutropin AQ Pen^® 20
• Nutropin AQ Pen^® 10
• Nutropin AQ^®

GH and GH therapy FAQs

Click questions to see answers.

How is growth hormone made in the body?

A: Growth hormone (often referred to as hGH, or simply GH) is a protein that is produced by the pituitary gland (an organ about the size of a pea, located at the base of the brain) and is released into the bloodstream.

What does growth hormone in the body do?

A: As its name suggests, growth hormone is the chief hormone responsible for growth. It stimulates the development of muscles and bones, and also helps regulate metabolism. Growth hormone travels to the cartilage, then causes the cartilage to grow and turn into bone. It is also involved in the production of muscle protein and in the breakdown of fats.

In adults, as well as in children, growth hormone is essential to the maintenance of healthy body composition and metabolism. Throughout adulthood, growth hormone plays an important role in maintaining an improved ratio of body fat to lean mass, “bad” to “good” cholesterol levels, and proper bone mineral density.

What is Nutropin?

A: Nutropin is a growth hormone produced by Genentech using recombinant DNA technology. It has the same amino acid sequence as growth hormone produced naturally in the human body. Genentech’s first growth hormone product was approved by the FDA in 1985.

How is Nutropin given?

A: Nutropin is injected into the subcutaneous tissue (the fatty layer under the skin). Your healthcare professional will instruct you on the method of administration that has been prescribed for you or your child.

Why must Nutropin be given by injection?

A: Nutropin medication must be given by injection because it is a protein. If the medication were taken by mouth, it would be broken down by digestion in the stomach and intestines and would never get to the rest of the body to do its job.

What should I do if an injection is missed?

A: Missing injections may interfere with the effectiveness of the medication. Talk to your healthcare professional if this should happen. Don’t try to make up for missed injections by “doubling up” on injections.

Is Nutropin used to treat other conditions?

A: Nutropin and Nutropin AQ^® [somatropin (rDNA origin) injection] are also indicated to treat growth failure associated with Turner Syndrome, growth failure associated with chronic renal insufficiency up to the time of transplant, idiopathic short stature and adult growth hormone deficiency.

When can I expect to see results from my Nutropin therapy?

A: It may be a number of months until you see the results of your Nutropin therapy. The changes may be so gradual at first that they are difficult to notice, but try not to get discouraged. Take your replacement therapy as your healthcare professional instructs. If you take it every day and don’t miss doses, you may improve the likelihood of positive results. Results may vary.

Can I take Nutropin with other medicines?

A: 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. Tell your doctor if you are given any new medication, especially glucocorticoid steroids like hydrocortisone or prednisone, and about ANY other condition or illness you have or develop.

Will Nutropin therapy be covered by my insurance?

A: Nutropin is generally covered by insurance, though documentation from the healthcare professional’s office is needed. Nutropin GPS can help you through the insurance authorization process.

What risk and side effect information about Nutropin should I be aware of?

A: Your child’s healthcare professional is your primary source of information. Discuss the potential benefits and risks of growth hormone (GH) treatment with your child’s pediatric endocrinologist so you are familiar with possible side effects.

If your child is treated at the hospital for any reason, notify your child’s healthcare professional, including your child’s pediatric endocrinologist, immediately.

It is important to notify your child’s doctor if allergic reactions occur, such as itching, rash, redness, or swelling at the injection site.

Should your child develop a limp or worsened curvature of the spine, or complain of hip or knee pain, notify your child’s doctor. If your child complains of headache, visual changes, nausea, and/or vomiting, notify your child’s healthcare professional immediately.

If your child has diabetes, consult your child’s doctor, as GH may affect the body’s response to insulin.

Discuss with your child’s doctor all medications your child is taking, particularly corticosteroids (such as prednisone or hydrocortisone), sex steroids (such as estrogens or testosterone), seizure medication, or cyclosporine.

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> What should I know about Nutropin and my safety?

Nutropin AQ NuSpin FAQs

Click questions to see answers about Nutropin AQ NuSpin.

What type of needles should I use?

A: Ask your healthcare professional which needle is appropriate for you. If the optional needle shield is used with the NuSpin 5, 10, or 20, needles 8 mm (5/16”) or longer should be used. Pen needles from other countries may not fit the NuSpin device. If you travel outside the United States, be sure to take enough needles for the duration of your stay.

Should I change the needle every time I use the NuSpin?

A: Yes. A new needle must be used for every injection. The needle is sterile only for one single injection.

When you’re done, slide the used needle into the outer cover. Carefully secure the outer cover over the entire needle, unscrew the needle, and dispose of it in your sharps container.

Learn more about how to properly dispose of your needles, and get tips for traveling with your GH medication.

Do I prime the NuSpin before each use?

A: No. The NuSpin only needs to be primed once, at first use.

When and how should I dispose of the NuSpin?

A: The NuSpin device is prefilled and the cartridge cannot be replaced. When the NuSpin device is empty, simply dispose of the entire device. If the empty NuSpin is disposed of with the needle attached, discard the entire device using the same procedure you use for needle disposal.

Learn more about how to properly dispose of your needles, and get tips for traveling with your GH medication.

Where should I store the NuSpin?

A: When it is not in use, store your NuSpin, without the needle, inside a refrigerator at 36°F to 46°F (2°C to 8°C) to maintain the potency of Nutropin AQ inside it. Keep the NuSpin outside of the refrigerator for no more than one hour per day. When you travel, place the NuSpin in a water-resistant container and put it in a cooler. DO NOT FREEZE. KEEP DRY.

What should I do if the NuSpin is dropped or damaged?

A: If you drop your NuSpin, always check to see if it is damaged. Be sure that the black dose knob and the Activator are moving properly. If the NuSpin is damaged, call your specialty pharmacy for a replacement, or call 1-866-NUTROPIN (1-866-688-7674).

How should I clean the NuSpin?

A: Use a damp cloth. Do not place it underwater. Do not use alcohol.

What risk and side effect information about Nutropin should I be aware of?

A: Your child’s healthcare professional is your primary source of information. Discuss the potential benefits and risks of growth hormone (GH) treatment with your child’s pediatric endocrinologist so you are familiar with possible side effects.

If your child is treated at the hospital for any reason, notify your child’s healthcare professional, including your child’s pediatric endocrinologist, immediately.

It is important to notify your child’s doctor if allergic reactions occur, such as itching, rash, redness, or swelling at the injection site.

Should your child develop a limp or worsened curvature of the spine, or complain of hip or knee pain, notify your child’s doctor. If your child complains of headache, visual changes, nausea, and/or vomiting, notify your child’s healthcare professional immediately.

If your child has diabetes, consult your child’s doctor, as GH may affect the body’s response to insulin.

Discuss with your child’s doctor all medications your child is taking, particularly corticosteroids (such as prednisone or hydrocortisone), sex steroids (such as estrogens or testosterone), seizure medication, or cyclosporine.

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Nutropin AQ Pen 20 FAQs

Click questions to see answers.

Do I need to change the needle every time I use my Nutropin AQ Pen 20?

A: Yes. We recommend that a new needle be used for each injection. The needle is only sterile on its first use.

Where should I store my Nutropin AQ Pen 20?

A: Your Nutropin AQ Pen 20 should be stored in the case, inside a refrigerator when a cartridge is inserted. When you travel, place your pen case in a waterproof container inside a cooler with an ice pack. DO NOT FREEZE OR IMMERSE IN WATER.

Why do I keep my medication in the refrigerator?

A: To maintain the potency of Nutropin AQ.

Can I store my Nutropin AQ Pen 20 in the freezer?

A: No. Freezing will damage the pen and drug.

How long can I keep my Nutropin AQ Pen 20 and 20 mg Cartridge outside the refrigerator?

A: We recommend no longer than one hour per day. Your healthcare professional will advise you regarding pen storage.

How much GH can my Nutropin AQ Pen 20 deliver in one injection?

A: 8 mg. If you attempt to dose more than 8 mg at a time, the drug will either be forced out of the needle and wasted or excess pressure will be placed upon the cartridge.

Is it possible to turn the black dose knob back if I click too many times?

A: Yes. You can turn the black dose knob backwards until the correct number appears in the LCD.

What should I do if there is not enough medication left in the cartridge to meet my dosing requirements?

A: Your healthcare professional will advise you on the procedure for the last dose in the cartridge.

Why do I have to rewind the black dose knob on my Nutropin AQ Pen 20 every time I replace the cartridge?

A: This ensures that the plunger push rod completely resets itself back to the starting position. If this is not done, liquid will come out of the needle when a new cartridge is placed into the pen.

Can I use my Nutropin AQ Pen 20 without the shields?

A: Yes. Your Nutropin AQ Pen 20 is fully functional without the shields. The shields are optional to help you administer your injection.

Where is the best place on my body to inject my medication?

A: Click here for some of the best injection sites. Consult your healthcare professional for more information.

What should I do if I drop my Nutropin AQ Pen 20?

A: If you drop the Nutropin AQ Pen 20, check to see if the cartridge is damaged. You should also check the pen to see that the black dose knob is moving up and down properly and that the LCD counter is working. If you discover or suspect damage to your cartridge or pen, notify your healthcare professional/pharmacy for a replacement.

How long can I use my Nutropin AQ Pen 20?

A: The Nutropin AQ Pen 20 is designed to last 24 months from the time you first use your pen.

But if you suspect your pen is damaged, call your specialty pharmacy for a replacement, or call 1-866-NUTROPIN (1-866-688-7674).

What does “bt” (blinking or steady) mean in the LCD?

A: The battery in your Nutropin AQ Pen 20 is losing its charge. Please contact your healthcare professional/pharmacy for a replacement pen. Batteries typically last 24 months and have a 4-week life from the time the “bt” first appears.

How do I replace my Nutropin AQ Pen 20?

A: Contact your healthcare professional/pharmacy if you need a replacement part or if you need to replace your entire pen.

How do I use the dose recall function?

A: If you would like to use the dose recall function for future injections, wait at least 2 minutes after your previous injection before pressing the white reset button.

Is the Nutropin AQ Pen 20 waterproof?

A: No. Exposure to moisture may cause the Nutropin AQ Pen 20 LCD window to malfunction. Do not immerse the Nutropin AQ Pen 20 in water. If the Nutropin AQ Pen 20 is accidentally immersed, remove it from the water and dry it immediately. If you are concerned that the device is not functioning properly, call 1-866-NUTROPIN (1-866-688-7674).

What does it mean when either “—-” or “———” flashes or appears steady on the digital dose display?

A: It means this pen has been used for 2 years and should be replaced. Your pen has 4 weeks of life remaining from the time that the flashing bars first appear. Ask your healthcare professional for a replacement Nutropin AQ Pen 20.

What risk and side effect information about Nutropin should I be aware of?

A: Your child’s healthcare professional is your primary source of information. Discuss the potential benefits and risks of growth hormone (GH) treatment with your child’s pediatric endocrinologist so you are familiar with possible side effects.

If your child is treated at the hospital for any reason, notify your child’s healthcare professional, including your child’s pediatric endocrinologist, immediately.

It is important to notify your child’s doctor if allergic reactions occur, such as itching, rash, redness, or swelling at the injection site.

Should your child develop a limp or worsened curvature of the spine, or complain of hip or knee pain, notify your child’s doctor. If your child complains of headache, visual changes, nausea, and/or vomiting, notify your child’s healthcare professional immediately.

If your child has diabetes, consult your child’s doctor, as GH may affect the body’s response to insulin.

Discuss with your child’s doctor all medications your child is taking, particularly corticosteroids (such as prednisone or hydrocortisone), sex steroids (such as estrogens or testosterone), seizure medication or cyclosporine.

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Nutropin AQ Pen 10 FAQs

Click questions to see answers.

Do I need to change the needle every time I use my Nutropin AQ Pen 10?

A: Yes. We recommend that a new needle be used for each injection. The needle is only sterile on its first use.

Where should I store my Nutropin AQ Pen 10?

A: Your Nutropin AQ Pen 10 should be stored in the case, inside a refrigerator when a cartridge is inserted. When you travel, place your Nutropin AQ Pen in a waterproof container inside a cooler with an ice pack. DO NOT FREEZE OR IMMERSE IN WATER.

Why do I keep my medication in the refrigerator?

A: To maintain the potency of Nutropin AQ.

Can I store my Nutropin AQ Pen 10 in the freezer?

A: No. Freezing will damage the pen and drug.

How long can I keep my Nutropin AQ Pen 10 and 10 mg Cartridge outside the refrigerator?

A: We recommend no longer than one hour per day. Your healthcare professional will advise you regarding pen storage.

What is the maximum dose the Nutropin AQ Pen 10 can deliver in one injection?

A: The maximum dose that may be delivered in one injection is 4 mg. If you attempt to dose more than 4 mg at a time, the drug will either be forced out of the needle and wasted or excess pressure will be placed upon the cartridge.

Is it possible to turn the black dose knob back if I click too many times?

A: Yes. You can turn the black dose knob backwards until the correct number appears in the LCD.

What should I do if there is not enough medication left in the cartridge to meet my dosing requirements?

A: Your healthcare professional will advise you on the procedure for the last dose in the cartridge.

Why do I have to rewind the black dose knob on my Nutropin AQ Pen 10 every time I replace the cartridge?

A: This ensures that the plunger push rod completely resets itself back to the starting position. If this is not done, liquid will come out of the needle when a new cartridge is placed into the pen.

Can I use my Nutropin AQ Pen 10 without the shields?

A: Yes. Your Nutropin AQ Pen 10 is fully functional without the shields. The shields are optional to help you administer your injection.

Where is the best place on my body to inject my medication?

A: Click here for some of the best injection sites. Consult your healthcare professional for more information.

What should I do if I drop my Nutropin AQ Pen 10?

A: If you drop the Nutropin AQ Pen 10, check to see if the cartridge is damaged. You should also check the pen to see that the black dose knob is moving up and down properly and that the LCD counter is working. If you discover or suspect damage to your cartridge or pen, notify your healthcare professional/pharmacy for a replacement.

How long can I use my Nutropin AQ Pen 10?

A: The Nutropin AQ Pen 10 is designed to last 24 months from the time you first use your pen.

But if you suspect your pen is damaged, call your specialty pharmacy for a replacement, or call 1-866-NUTROPIN (1-866-688-7674).

What does “bt” (blinking or steady) mean in the LCD?

A: The battery in your Nutropin AQ Pen 10 is losing its charge. Please contact your healthcare professional/pharmacy for a replacement pen. Batteries typically last 24 months and have a 4-week life from the time the “bt” first appears.

How do I replace my Nutropin AQ Pen 10?

A: Contact your healthcare professional/pharmacy if you need a replacement part or if you need to replace your entire pen.

How do I use the dose recall function?

A: If you would like to use the dose recall function for future injections, wait at least 2 minutes after your previous injection before pressing the white reset button.

Is the Nutropin AQ Pen 10 waterproof?

A: No. Exposure to moisture may cause the Nutropin AQ Pen 10 LCD window to malfunction. Do not immerse the Nutropin AQ Pen 10 in water. If the Nutropin AQ Pen 10 is accidentally immersed, remove it from the water and dry it immediately. If you are concerned that the device is not functioning properly, call 1-866-NUTROPIN (1-866-688-7674).

What does it mean when either “—-” or “———” flashes or appears steady on the digital dose display?

A: It means this pen has been used for 2 years and should be replaced. Your pen has 4 weeks of life remaining from the time that the flashing bars first appear. Ask your healthcare professional for a replacement Nutropin AQ Pen 10.

What risk and side effect information about Nutropin should I be aware of?

A: Your child’s healthcare professional is your primary source of information. Discuss the potential benefits and risks of growth hormone (GH) treatment with your child’s pediatric endocrinologist so you are familiar with possible side effects.

If your child is treated at the hospital for any reason, notify your child’s healthcare professional, including your child’s pediatric endocrinologist, immediately.

It is important to notify your child’s doctor if allergic reactions occur, such as itching, rash, redness, or swelling at the injection site.

Should your child develop a limp or worsened curvature of the spine, or complain of hip or knee pain, notify your child’s doctor. If your child complains of headache, visual changes, nausea, and/or vomiting, notify your child’s healthcare professional immediately.

If your child has diabetes, consult your child’s doctor, as GH may affect the body’s response to insulin.

Discuss with your child’s doctor all medications your child is taking, particularly corticosteroids (such as prednisone or hydrocortisone), sex steroids (such as estrogens or testosterone), seizure medication or cyclosporine.

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Nutropin AQ FAQs

Click questions to see answers.

Why do I have to rotate injection sites?

A: Even if you develop a preference for one site over another, alternating injection sites with each injection helps to reduce the chances of problems developing at the injection site. Notify your doctor if any of the following symptoms are noticed at an injection site:

• A lump that doesn’t go away
• Bruising that doesn’t go away
• Any signs of infection or inflammation such as swelling, pus, persistent redness or pain, or skin that is hot to the touch

Can I travel while on Nutropin AQ therapy?

A: Yes. You should continue to administer the injections while you are away from home. Supplies should be protected from light and kept inside a travel cooler, where they can be kept cold (36°–46°F/2°–8°C) but NEVER FROZEN. Do not continue to use a Nutropin AQ Cartridge more than 28 days after first use. Check with your travel agent or airline to find out about any rules that might affect the transport of medication and injection supplies on board a plane or into another country.

How long will my child have to take GH therapy?

A: GH therapy should be continued until the doctor determines that GH therapy should end.

My child takes medications for another condition. Will he have to continue on those medications while receiving Nutropin AQ therapy?

A: Tell your doctor about all the medications your child is taking. Your child may need other medications and, unless directed otherwise, they should not be stopped while on GH therapy.

I’m an adult taking other hormone medicines. Why do I need to take Nutropin AQ therapy?

A: Depending on the cause of adult GH deficiency (AGHD), many patients need to take other pituitary hormones. GH is produced by the pituitary gland—a small gland located at the base of the brain. This small gland is actually responsible for releasing and controlling many hormones in our bodies. Each of these hormones is released in tiny amounts 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, body composition, and lipid metabolism. Each of the other hormones released from the pituitary are important for other reasons—from salt and water regulation to helping our bodies deal with stress. Nutropin AQ cannot replace the function of these other hormones. Nor can other hormones replace the function of GH therapy.

What causes pituitary disease with adult-onset GH deficiency?

A: In adults, GH 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 GH deficiency. In the United States, approximately 50,000 adults have GH deficiency and 6000 new cases of AGHD are diagnosed each year. Children who receive GH therapy may need to continue with the therapy into adulthood if AGHD is confirmed.

What is a DEXA scan?

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 used to determine body composition, or the proportion of the 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 bone density and body composition. By taking a DEXA scan before you begin treatment, your doctor will have a baseline measurement of your bone density and the composition of your body.

Why should children with chronic renal failure (CRI) be on GH therapy?

A: Your doctor will determine whether GH therapy for CRI may be appropriate. One reason that children with CRI may suffer from abnormal growth and development is related to GH. In these children, GH does not work as well as it does in those who are healthy. Giving them GH may help them grow better.

How long will my child have to take Nutropin AQ therapy for growth failure in CRI?

A: Children with growth failure in CRI should continue to receive Nutropin AQ treatments up to the time of renal transplantation, subject to their healthcare professional’s medical judgment.

What are the risks of Nutropin therapy in CRI?

A: A small number of patients treated with GH have experienced pressure in the head (combined with visual changes, headache, nausea and/or vomiting). Patients with growth failure in CRI should have periodic check-ups for a type of bone disease called renal osteodystrophy. Additionally, some patients have experienced hip and/or knee pain, and others have experienced allergic reactions. Patients should contact their healthcare team immediately if they encounter these side effects.

Why are girls with Turner Syndrome short?

A: The most common feature of Turner Syndrome, short stature, affects 95% to 100% of girls with Turner Syndrome. The missing or incomplete X chromosomes contain a gene that helps children grow to a normal height. From birth through their teen years, girls with Turner Syndrome grow more slowly than unaffected children. The average adult height of unaffected women is 5’4” while women with Turner Syndrome average about 4’8” unless they receive GH treatment.

Who can take Nutropin AQ?

A: Doctors prescribe Nutropin AQ for children and teenagers with growth failure who:

• Do not make enough growth hormone on their own
• Have chronic renal insufficiency—a slow loss of kidney function—and have not had a transplant
• Have Turner Syndrome
• Are not likely to grow to their potential adult height, as determined by a doctor, and whose bones are still able to grow

Doctors prescribe Nutropin AQ for adults who:

• Have growth hormone deficiency that started either in childhood or as an adult due to brain surgery, radiation therapy, trauma, or diseases of the pituitary gland or the hypothalamus

Your doctor will test to see if growth hormone is right for you.

Who should not take Nutropin AQ?

A: 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 I am about to start taking Nutropin, or am already taking it, what should I tell the doctor who prescribed it?

A: Tell your doctor:

• 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 risk and side effect information about Nutropin should I be aware of?

A: our child’s healthcare professional is your primary source of information. Discuss the potential benefits and risks’rowth hormone (GH) treatment with your child’s pediatric endocrinologist so you are familiar with possible side effects.

If your child is treated at the hospital for any reason, notify your child’s healthcare professional, including your child’s pediatric endocrinologist, immediately.

It is important to notify your child’s doctor if allergic reactions occur, such as itching, rash, redness, or swelling at the injection site. Should your child develop a limp or worsened curvature of the spine, or complain of hip or knee pain, notify your child’s doctor. If your child complains of headache, visual changes, nausea, and/or vomiting, notify your child’s healthcare professional immediately.

If your child has diabetes, consult your child’s doctor, as GH may affect the body’s response to insulin.

Discuss with your child’s doctor all medications your child is taking, particularly corticosteroids (such as prednisone or hydrocortisone), sex steroids (such as estrogens or testosterone), seizure medication or cyclosporine.

At what time of day should Nutropin therapy be given?

A: You should establish a consistent routine for the timing of the injection. For example, every night at bedtime or right before dinner every night may be easy to remember.

How should the timing of injections be handled with patients on dialysis?

A: to optimize therapy for patients who require dialysis, the following guidelines for injection schedule are recommended:

• Hemodialysis patients should receive their injection at night, just prior to going to sleep or at least 3 to 4 hours after hemodialysis. This helps to prevent the GH injection from causing a hematoma due to heparin exposure during dialysis
• Continuous cycling peritoneal dialysis (CCPD) patients should receive their injection in the morning after they have completed dialysis
• Continuous ambulatory peritoneal dialysis (CAPD) patients should receive their injection in the evening at the time of the overnight exchange. Healthcare professionals should assess your overall treatment plan to determine the best time of day to administer Nutropin therapy

Where should I go for insurance questions?

A: Call your doctor’s office, your specialty pharmacy, or call Nutropin GPS at 1-866-NUTROPIN (1-866-688-7674) between the hours of 6 am and 5 pm PT, Monday through Friday.

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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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