Growth hormone deficiency
Synthetic Human Growth Hormone - preferred products for use in the majority of patients are: Norditropin and Omnitrope.
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Gonadal dysgenesis (Turner syndrome), by subcutaneous injection, 1.4 mg/m2 daily, alternatively 45-50 micrograms/kg daily.
Deficiency of growth hormone, by subcutaneous injection, initially 150-300micrograms daily, then increased if necessary up to 1mg daily, dose to be increased gradually, use minimum effective dose (requirements may decrease with age).
Prescribing Notes:
- NICE TA188 states that there appears to be no differences in the clinical effectiveness of the various somatropin devices, although patient choice is an important factor to consider.
- For patients with specific needs, products such as Genotropin, Zomacton, Saizen and NutropinAq may be considered.
- Somatropin is most effective if administered in the evening.
- Dose adjustment may be required over time depending on increased body surface area and response.
- The advice regarding administration and storage conditions following reconstitution differs for different brands of somatropin; refer to the Summary of Product Characteristics for detail.
- Parents should be advised not to shake the vial as this may denature growth hormone.
- Although products are clinically interchangeable, it is important that the patient remains on the same preparations for consistency. Select the product of lowest acquisition cost which is considered suitable for the individual patient.
- Somatropin is appropriate for a shared care arrangement to facilitate the seamless transfer of individual patient care from secondary care to general practice.
History Notes
15/04/2024
Norditropin NordiFlex and Humatrope products removed as discontinued.
11/05/2023
Norditropin SimpleXx cartridges removed as discontinued.
16/02/2022
East Region Formulary content agreed.
Synthetic Human Growth Hormone - preferred products for use in the majority of patients are: Norditropin and Omnitrope.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
For dose, refer to BNF for Children and follow specialist advice.
Prescribing Notes:
- NICE TA188 states that there appears to be no differences in the clinical effectiveness of the various somatropin devices, although patient choice is an important factor to consider.
- For patients with specific needs, products such as Genotropin, Zomacton, Saizen and NutropinAq may be considered.
- Somatropin is most effective if administered in the evening.
- Dose adjustment may be required over time depending on increased body surface area and response.
- The advice regarding administration and storage conditions following reconstitution differs for different brands of somatropin; refer to the Summary of Product Characteristics for detail.
- Parents should be advised not to shake the vial as this may denature growth hormone.
- Although products are clinically interchangeable, it is important that the patient remains on the same preparations for consistency. Select the product of lowest acquisition cost which is considered suitable for the individual patient.
- Somatropin is appropriate for a shared care arrangement to facilitate the seamless transfer of individual patient care from secondary care to general practice.
- Refer to guidance in Scottish Paediatric Endocrine Group and British Society for Paediatric Endocrinology and Diabetes.
History Notes
29/02/2024
East Region Formulary content agreed.