Somatropin (Recombinant Human Growth Hormone)

How it works

It replaces endogenous growth hormone, binding growth hormone receptors to stimulate linear growth, protein synthesis and lipolysis, with many effects mediated through IGF-1.

Prescribing in practice

• Somatropin is contraindicated in active malignancy and in acutely critically ill patients, and should not be used where there is evidence of active tumour.
• It can impair glucose tolerance and unmask diabetes, and may reduce cortisol and thyroxine levels, so other pituitary axes and glucose should be assessed and replaced as needed.
• In children, benign intracranial hypertension and slipped capital femoral epiphysis have been reported, so new headaches, visual changes or hip or knee pain should be evaluated.

Monitoring

Monitor growth and IGF-1, together with glucose, thyroid and adrenal function and, in children, the spine and visual symptoms, throughout treatment.

Counselling the patient

• Rotate injection sites and store the product as directed to maintain stability.
• Report persistent headaches, vision changes, or hip or knee pain in children.
• Report increased thirst or urination, which may indicate effects on blood sugar.

Evidence & guidelines

Somatropin is a long-established replacement therapy whose indications and safety profile are detailed in the SPC and reflected in relevant NICE technology appraisals.