Frequently Asked Questions
About Nutropin AQ® (somatropin)
Responses to the Frequently Asked Questions below combine to deliver key clinical, safety, and administrative information on different aspects of Nutropin therapy.
Conditions Treated by Nutropin AQ
GHD occurs when the pituitary gland does not make enough growth hormone (GH). This problem may be present at birth as the result of a congenital defect in the pituitary gland or hypothalamus. Acquired GHD may be caused by damage to the pituitary at any time after birth. Decreased pituitary gland function leading to GHD may be caused by a brain tumor, cranial and/or spinal radiation treatment for cancer, severe head trauma, infection, or surgical removal of the pituitary gland. If GH is the only hormone that is affected, the condition is referred to as isolated GHD. Sometimes no specific cause for the GHD can be found; this is called idiopathic GHD.
Patients with GHD may have other hormone deficiencies.
Hypopituitarism is the decrease in, or absence of, one or more of the pituitary hormones. These hormones may include:
- Growth hormone (GH)
- Adrenocorticotropic hormone (ACTH)
- Thyroid-stimulating hormone (TSH)
- Gonadotropins, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
- Antidiuretic hormone (ADH)
Patients with GHD who also have deficiencies in these hormones may have additional medications prescribed to provide adequate hormone replacement. These patients need to be followed closely by an endocrinologist.
GH is a modulator of carbohydrate metabolism. For example, patients with inadequate secretion of GH sometimes experience fasting hypoglycemia that is improved by treatment with Nutropin AQ. Somatropin therapy may decrease insulin sensitivity.
In adults, AGHD 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 AGHD. Children who receive GH therapy may need to continue with the therapy into adulthood if AGHD is confirmed.
ISS or non−growth hormone−deficient short stature is when a child or a teenager is growing poorly, but his or her body appears to be making normal amounts of growth hormone. Children with ISS have heights that are at least 2.25 standard deviations below average for their age/sex and growth rates that indicate a low chance of reaching a normal adult height.
TS is a genetic condition in females that results from a missing or abnormal X (female) chromosome. Many physical features are associated with TS, but few females have all of the features. However, nearly all girls with TS have abnormal growth. Even though their bodies produce GH, they do not grow normally and will have a significantly lower-than-average adult height if not treated.
Growth failure is a common and clinically significant concern in children with CKD. These children typically have increased GH levels but show reduced responsiveness to endogenous GH and insulin-like growth factor-I (IGF-I). An abnormal GH–IGF-I axis, coupled with a variety of nutritional and metabolic problems, is thought to be the underlying etiology of growth disorders seen in this patient population.
The goal of Nutropin therapy for a child with CKD is determined by the ordering HCP and may include offsetting the impact of CKD on the growth process to help the child get closer to his or her full adult height potential. Children with CKD may continue to receive Nutropin treatments up to the time of renal transplantation.
- Hemodialysis patients should receive their injection at night just prior to going to sleep or at least 3-4 hours after their hemodialysis to prevent hematoma formation due to the heparin
- Chronic cycling peritoneal dialysis (CCPD) patients should receive their injection in the morning after they have completed dialysis
- Chronic ambulatory peritoneal dialysis (CAPD) patients should receive their injection in the evening at the time of the overnight exchange