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While you should always discuss any concerns with your healthcare professional, think of these questions and answers as a good place to start:

What is pediatric growth hormone deficiency?

A: Pediatric growth hormone deficiency (PGHD) occurs when the production of growth hormone is disrupted during infancy or childhood. Essentially, it occurs when the pituitary gland of an infant or a child fails to produce growth hormone, or secretes inadequate amounts of the hormone.

How is pediatric growth hormone deficiency diagnosed?

A: Pediatric growth hormone deficiency is diagnosed through special blood tests that detect growth hormone in the blood.

What are the effects of pediatric growth hormone deficiency?

A: The decreased levels of growth hormone associated with pediatric growth hormone deficiency may result in abnormalities of many body processes—including growth and development, production of muscle protein, and breakdown of fats.

Is pediatric growth hormone deficiency very common? What causes it?

A: Although pediatric growth hormone deficiency is uncommon, it may occur at any time during infancy or childhood, and there are many possible causes. Some involve damage to the pituitary gland or the hypothalamus, a part of the brain that controls the pituitary.

What are the signs of pediatric growth hormone deficiency?

A: A major sign of pediatric growth hormone deficiency is a marked slowing of growth. Many children with growth hormone deficiency have normal body proportions and normal intelligence, although some may be overweight for their height or have problems with low blood sugar.

For how long will my child have to take Nutropin therapy?

A: Typically, your child may continue taking injections of Nutropin until the doctor determines that GH therapy should end. At that time, there may be additional tests to determine whether or not the growth hormone deficiency may persist into adulthood.

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.

Since Nutropin/Nutropin AQ have the same DNA sequence as the GH produced in the body, do allergic reactions happen?

A: Yes. As with any protein, local or systemic allergic reactions may occur.

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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