indication

For treatment of dwarfism, acromegaly and prevention of HIV-induced weight loss

pharmacology

Used in the treatment of dwarfism and growth failure, growth hormone (hGH) stimulates skeletal growth in pediatric patients with growth failure due to a lack of adequate secretion of endogenous GH. Skeletal growth is accomplished at the epiphyseal plates at the ends of a growing bone. Growth and metabolism of epiphyseal plate cells are directly stimulated by GH and one of its mediators, IGF-I (insulin-like growth factor).

mechanism of action

hGH binds to the human growth hormone receptor (GHR). Upon binding, hGH causes dimerization of GHR, activation of the GHR-associated JAK2 tyrosine kinase, and tyrosyl phosphorylation of both JAK2 and GHR. These events recruit and/or activate a variety of signaling molecules, including MAP kinases, insulin receptor substrates, phosphatidylinositol 3' phosphate kinase, diacylglycerol, protein kinase C, intracellular calcium, and Stat transcription factors. These signaling molecules contribute to the GH-induced changes in enzymatic activity, transport function, and gene expression that ultimately culminate in changes in growth and metabolism.

route of elimination

Although calcium excretion in the urine is increased, there is a simultaneous increase in calcium absorption from the intestine. Somatropin stimulates the synthesis of chondroitin sulfate and collagen, and increases the urinary excretion of hydroxyproline.

drug interactions

Acarbose: Somatropin may antagonize the hypoglycemic effect of acarbose. Monitor for changes in fasting and postprandial blood sugars.

Chlorpropamide: Somatropin may antagonize the hypoglycemic effect of chlorpropamide. Monitor for changes in fasting and postprandial blood sugars.

Exenatide: Somatropin may antagonize the hypoglycemic effect of exenatide. Monitor for changes in fasting and postprandial blood sugars.

Gliclazide: Somatropin may antagonize the hypoglycemic effect of gliclazide. Monitor for changes in fasting and postprandial blood sugars.

Glimepiride: Somatropin may antagonize the hypoglycemic effect of glimepiride. Monitor for changes in fasting and postprandial blood sugars.

Glipizide: Somatropin may antagonize the hypoglycemic effect of glipizide. Monitor for changes in fasting and postprandial blood sugars.

Glyburide: Somatropin may antagonize the hypoglycemic effect of glibenclamide. Monitor for changes in fasting and postprandial blood sugars.

Insulin Aspart: Somatropin may antagonize the hypoglycemic effect of insulin aspart. Monitor for changes in fasting and postprandial blood sugars.

Insulin Detemir: Somatropin may antagonize the hypoglycemic effect of insulin detemir. Monitor for changes in fasting and postprandial blood sugars.

Insulin Glargine: Somatropin may antagonize the hypoglycemic effect of insulin glargine. Monitor for changes in fasting and postprandial blood sugars.

Insulin Glulisine: Somatropin may antagonize the hypoglycemic effect of insulin glulisine. Monitor for changes in fasting and postprandial blood sugars.

Liraglutide: Somatropin may antagonize the hypoglycemic effect of liraglutide. Monitor for changes in fasting and postprandial blood sugars.

Metformin: Somatropin may antagonize the hypoglycemic effect of metformin. Monitor for changes in fasting and postprandial blood sugars.

Miglitol: Somatropin may antagonize the hypoglycemic effect of miglitol. Monitor for changes in fasting and postprandial blood sugars.

Nateglinide: Somatropin may antagonize the hypoglycemic effect of nateglinide. Monitor for changes in fasting and postprandial blood sugars.

Pioglitazone: Somatropin may antagonize the hypoglycemic effect of pioglitazone. Monitor for changes in fasting and postprandial blood sugars.

Rosiglitazone: Somatropin may antagonize the hypoglycemic effect of rosiglitazone. Monitor for changes in fasting and postprandial blood sugars.

Saxagliptin: Somatropin may antagonize the hypoglycemic effect of saxagliptin. Monitor for changes in fasting and postprandial blood sugars.

Sitagliptin: Somatropin may antagonize the hypoglycemic effect of sitagliptin. Monitor for changes in fasting and postprandial blood sugars.

Tolazamide: Somatropin may antagonize the hypoglycemic effect of Tolazamide. Dose adjustments of Tolazamide may be required.

Tolbutamide: Somatropin may antagonize the hypoglycemic effect of Tolbutamide. Dose adjustments of Tolbutamide may be required.