Genotropin

Before taking this medicine

Somatropin should not be used in people with: • Acute critical illness following open-heart or abdominal surgery, multiple accidental injuries, or acute respiratory failure. • Active cancer, or evidence that a brain tumour is growing or has returned. Any previous cancer must be inactive and its treatment completed before starting therapy. • A known allergy to somatropin or any ingredient in the medicine. • Active proliferative or severe non-proliferative diabetic retinopathy, forms of diabetes-related eye disease. It must not be used in children with Prader-Willi syndrome who are severely obese, have a history of upper airway obstruction or sleep apnoea, or have severe breathing impairment. Sudden deaths have been reported in these patients. It should not be used to promote growth in children whose growth plates have closed. Conditions requiring caution include previous tumours, diabetes or impaired glucose tolerance, low adrenal hormone levels, an underactive thyroid and existing scoliosis. Patients with previous tumours need monitoring for growth or recurrence. Childhood cancer survivors treated with somatropin have an increased risk of a second tumour, particularly meningioma after radiation to the head. Blood glucose, thyroid function and adrenal function may need monitoring. Somatropin can cause fluid retention, swelling, joint pain and carpal tunnel syndrome, especially in adults. Raised pressure inside the skull may occur; swelling of the optic nerve must be excluded before treatment. Children with Prader-Willi syndrome need assessment for airway obstruction and sleep apnoea before treatment; treatment should be stopped if these signs develop. A new limp or hip or knee pain in a child needs medical assessment. Persistent severe abdominal pain may indicate pancreatitis. Seek prompt medical attention for an allergic reaction. If acute critical illness develops during treatment, the prescriber must weigh the potential benefits and risks of continuing.