Replacement therapy in adults w/ pronounced growth hormone deficiency (GHD). Growth disturbance due to insufficient secretion of growth hormone & associated w/ Turner syndrome or chronic renal insufficiency in childn. Growth disturbance in short childn born small for gestational age (SGA) w/ birth wt &/or length <2 SD, who failed to show catch-up growth by ≥4 yr. Prader-Willi syndrome (PWS) for improvement of growth & body composition.
Discontinue use if papilloedema is confirmed. Not recommended to initiate treatment near onset of puberty in short childn born SGA. Not to be used in patients w/ acute critical illness suffering complications following open heart or abdominal surgery, multiple accidental trauma or acute resp failure. Leukemia; myositis; pancreatitis. Assess signs for upper airway obstruction, sleep apnoea or resp infections prior to treatment. May reduce insulin sensitivity. Closely monitor patients w/ diabetes, glucose intolerance or additional risk factors for diabetes during therapy. Monitor symptoms of intracranial HTN if treatment is restarted; thyroid function & signs of scoliosis during treatment. May unmask previously undiagnosed central hypoadrenalism. Ab formation; relapse of GHD secondary to malignant disease treatment. Strict calorie-restricted diet & wt control in patients w/ PWS. Measure fasting insulin & blood glucose prior to & annually in SGA childn. Assess renal function prior to initiation of therapy. Concomitant use w/ oral oestrogen therapy. Discontinue treatment at renal transplantation. Not recommended during pregnancy & in women of childbearing potential not using contraception. Lactation. Elderly >80 yr. Examine childn limping during treatment.
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 5.3 mgfe4d0410-0baa-4abc-a4b4-a61300fdda6b.GIF)
