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lanreotide (somatotropin, growth hormone, GH, hGH, rhGH, Humatrope, Protropin, Serostim, Somatrem, Somatuline)

Tradenames: Humatrope, Protropin, Serostim Indications: 1) long-term treatment of growth failure from lack of adequate endogenous growth hormone - dwarfism [8] 2) treatment of AIDS wasting or cachexia (Serostim) 3) growth hormone deficiency in the elderly? Contraindications: 1) proliferative diabetic retinopathy 2) malignancy Dosage: 1) somatrem (Protropen): 0.1 mg (0.26 units)/kg/dose 3X/week 2) somatropin a) Humatrope: 0.06 mg (0.16 units)/kg/dose 3X/week b) Serostim: 0.1 mg/kg SC QHS c) Somatuline: 60-120 mg IM every 4 weeks - injected in the superior external quadrant of the buttock; injection site should be alternated [8] 3) 5-10 ug/kg/day SC QHS Therapy should be discontinued when patient has reached a satisfactory adult height, when epiphyses have fused, or when patient ceases to respond. Injection: 1) somatrem (Protropin) 5 mg - 13 units 2) somatropin a) Humatrope: 3 mg = 13 units b) Serostim: 6 mg = 18 units Monitor: serum IGF-1 Adverse effects: 1) common [8] - diarrhea (37%) - cholelithiasis (20%) - abdominal pain (19%) - nausea (11%) - injection-site reaction (9%) - flatulence (7%) - arthralgia (7%) 2) not common (1-10%) - hypothyroidism 3) uncommon (< 1%) - hyperglycemia - small risk of developing leukemia - pain at site of injection - rash, itching - pain in knee &/or hip 4) other [2] {dose-dependent} - fluid retention - glucose intolerance - carpal tunnel syndrome - gynecomastia, breast tenderness - increased risk of death Complications: -> adrenal insufficiency in unrecognized ACTH deficiency [3] Mechanism of action: 1) stimulates IGF-1 secretion 2) increased lean body mass 3) increased bone mass 4) increased skin thickness 5) decreased adipose tissue 6) does not add to beneficial effect of exercise 7) does not improve athletic performance [6] Notes: - teen use - black & Hispanic teens more likely than white teens to use HGH (15% & 13%, respectively, vs. 9%) - both boys & girls use synthetic HGH (12% & 9%, respectively) - 81% of teens view HGH use moderately to very risky [9]

Related

acromegaly growth hormone (GH) stimulation test growth hormone (GH) suppression test; glucose challenge test for acromegaly growth hormone (somatotropin) in serum growth hormone receptor; GH receptor; somatotropin receptor; contains: growth hormone-binding protein; GH-binding protein; GHBP; serum-binding protein (GHR) growth hormone-releasing hormone; somatotropin-releasing hormone,; somatocrinin; somatoliberin (GHRH) pituitary adenoma/GH secreting (somatotrophinoma)

General

somatotropin; growth hormone; somatropin (GH) endocrine agent

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Solomon DH, in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  3. Adrenal Crisis Causes Deaths in People Who Got hGH http://www.niddk.nih.gov/health/endo/pubs/creutz/alert.htm
  4. Follow-Up Study of NHPP Growth Hormone Recipients http://www.niddk.nih.gov/health/endo/pubs/creutz/update.htm
  5. Weinreb J, in: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 29-Oct 2, 2004
  6. Liu H et al, Systematic review: the effects of growth hormone on athletic performance Annals of Internal Medicine 2008 148: (20 May 2008) PMID: 18347346
  7. FDA MedWatch Recombinant Human Growth Hormone (somatropin): Ongoing Safety Review - Possible Increased Risk of Death http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm237969.htm
  8. Deprecated Reference
  9. The Partnership. Attitude Tracking Study. Teens & Parents 2013. http://www.drugfree.org/wp-content/uploads/2014/07/PATS-2013-FULL-REPORT.pdf
  10. Somatuline Depot http://www.somatulinedepot.com/