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Concomitant treatment with glucocorticoids inhibits the growth-promoting effects of somatropin containing products. Patients with adrenocorticotropic hormone (ACTH) deficiency should have their glucocorticoid replacement therapy carefully adjusted to avoid any inhibitory effect on growth. Therefore, patients treated with glucocorticoids should have their growth monitored carefully to assess the potential impact of glucocorticoid treatment on growth.
Growth hormone decreases the conversion of cortisone to cortisol and may unmask previously undiscovered central hypoadrenalism or render low glucocorticoid replacement doses ineffective (see Precautions).
Administration of somatropin may increase the clearance of compounds metabolized by cytochrome P4503A4 (e.g. sex steroids, corticosteroids, anticonvulsants, and cyclosporin). The clinical significance of this potential interaction is unknown.
In women on oral oestrogen replacement, a higher dose of growth hormone may be required to achieve the treatment goal (see Precautions).
