ZOMACTON (somatropin) for Injection
Indications
ZOMACTON is a recombinant human growth hormone (GH) indicated for the treatment of pediatric patients with:
- growth failure due to inadequate secretion of endogenous GH
- short stature associated with Turner syndrome
- idiopathic short stature (ISS)
- short stature or growth failure in short stature homeobox-containing gene (SHOX) deficiency
- short stature born small for gestational age (SGA) with no catch-up growth by 2 to 4 years
ZOMACTON is also indicated for the replacement of endogenous GH in adults with GH deficiency.
Contraindications
ZOMACTON is contraindicated in patients with:
- acute critical illness
- pediatric patients with Prader-Willi syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment due to the risk of death
- active malignancy
- hypersensitivity to ZOMACTON, its excipients, or diluents. Systemic hypersensitivity reactions, including anaphylaxis and angioedema, have been reported with postmarketing use of somatropins
- active proliferative or severe non-proliferative diabetic retinopathy
- pediatric patients with closed epiphyses
Warnings and Precautions
Increased Risk of Neoplasm: Second neoplasms have occurred in childhood cancer survivors. Monitor patients with preexisting tumors for progression or recurrence.
Glucose Intolerance and Diabetes Mellitus: ZOMACTON may decrease insulin sensitivity, particularly at higher doses. Monitor glucose levels periodically, especially in patients with existing diabetes mellitus or at risk for development.
Intracranial Hypertension (IH): Has been reported usually within 8 weeks of initiation. Perform fundoscopic examinations prior to initiation and periodically thereafter. If papilledema occurs, stop treatment.
Hypersensitivity: Serious hypersensitivity reactions may occur, including anaphylaxis and angioedema; seek prompt medical attention.
Fluid Retention: May occur in adults and may be dose dependent.
Hypoadrenalism: Monitor patients for reduced serum cortisol levels or need for glucocorticoid dose increases in those with known hypoadrenalism.
Hypothyroidism: Monitor thyroid function periodically as hypothyroidism may occur or worsen after initiation of somatropin.
Slipped Capital Femoral Epiphysis in Pediatric Patients: May occur; evaluate patients with onset of a limp or hip/knee pain for slipped capital femoral epiphysis and osteonecrosis and manage accordingly.
Progression of Preexisting Scoliosis in Pediatric Patients: Monitor patients with scoliosis for progression.
Pancreatitis: Has been reported; consider pancreatitis in patients with abdominal pain, especially pediatric patients.
Risk of Serious Adverse Reactions in Infants due to Benzyl Alcohol Preservative: Serious and fatal adverse reactions can occur in neonates and infants treated with benzyl alcohol-preserved drugs, including the diluent for ZOMACTON 5 mg. If administering ZOMACTON 5 mg to infants, reconstitute with 0.9% sodium chloride injection.
Adverse Reactions
Common adverse reactions reported include: upper respiratory infection, fever, pharyngitis, headache, otitis media, edema, arthralgia, paresthesia, myalgia, carpal tunnel syndrome, peripheral edema, flu syndrome, hypothyroidism, hyperglycemia, and impaired glucose tolerance.
Drug Interactions
Glucocorticoids: Patients treated with glucocorticoids may require an increased dose.
Pharmacologic Glucocorticoid Therapy and Supraphysysiologic Glucocorticoid Treatment: Adjust dosing in pediatric patients to avoid hypoadrenalism or an inhibitory effect on growth.
Cytochrome P450-Metabolized Drugs: Monitor carefully if used with ZOMACTON as clearance may be altered.
Oral Estrogen: Larger doses of ZOMACTON may be required.
Insulin or Other Hypoglycemic Agents: Dose adjustment may be required.
Use In Specific Populations
Pregnancy and Lactation: If ZOMACTON 5 mg is needed, reconstitute with 0.9% sodium chloride injection or use the ZOMACTON 10 mg benzyl alcohol-free formulation.
Please see Full Prescribing Information for ZOMACTON.
