Genotrop 100IU
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What is Genotrop?
Genotrop is a recombinant DNA-derived human growth hormone indicated for the treatment of growth failure, growth hormone deficiency, short stature associated with Turner syndrome or chronic kidney disease, and other growth disturbances. It is administered by subcutaneous injection and works by binding to growth hormone receptors to stimulate skeletal and somatic growth.
What is the mechanism of action of somatropin?
Somatropin is identical to natural growth hormone produced in the pituitary gland. It exerts its effects by binding to specific growth hormone receptors located throughout the body. This initiates a signaling cascade that stimulates the liver and other tissues to produce insulin-like growth factor 1 (IGF-1), the primary mediator of growth hormone's anabolic effects. IGF-1 then circulates and acts on its target cells to stimulate cellular growth, proliferation, and protein synthesis. In muscles and bones, IGF-1 promotes tissue growth and mineralization. In metabolic tissues, it increases amino acid uptake and protein synthesis, exerting an overall anabolic effect.
How is Genotrop administered and what is the dosing regimen?
Genotrop is administered via subcutaneous injection, typically into the abdomen, thighs, or upper arms. The dose is individualized based on the approved indication, the patient's clinical response, and serum IGF-1 concentrations. For pediatric growth hormone deficiency, a typical starting dose is 0.16-0.24 mg/kg/week (or 4-6 IU/kg/week) divided into daily doses. Doses are titrated based on growth velocity and side effects. Maximum recommended doses are 0.7 mg/kg/week. For adults, starting doses are typically 0.4-1.0 mg/day (1-3 IU/day), with maximum doses of about 2.0 mg/day. Injection sites should be rotated to avoid lipoatrophy.
What are the indications of Genotrop?
Genotrop is FDA-approved for the following indications:
- Treatment of pediatric growth failure due to inadequate secretion of endogenous growth hormone
- Treatment of growth failure associated with Turner syndrome or chronic kidney disease
- Treatment of adults with growth hormone deficiency
- For AIDS wasting/cachexia to increase lean body mass and improve physical endurance
It is also used off-label for idiopathic short stature and as an anti-aging treatment in older adults with natural somatopause.
What are the side effects and risks associated with Genotrop?
When used for approved indications and properly dosed, Genotrop is generally well tolerated. Potential side effects may include:
- Joint pain, muscle pain, or fluid retention as growth accelerates
- Numbness/tingling (may indicate carpal tunnel syndrome)
- Increased risk of scoliosis progression in children
- Hyperglycemia due to reduced insulin sensitivity
- Benign intracranial hypertension has occurred in a small percentage of patients
Rare but serious risks include:
- Increased growth of pre-existing tumors
- Impaired insulin sensitivity leading to type 2 diabetes
- Proliferative or preproliferative diabetic retinopathy
- Slipped capital femoral epiphysis in pediatric patients
Close monitoring of height, weight, and blood sugar is important during treatment. Thyroid function should also be assessed periodically.
What precautions should be taken with Genotrop treatment?
Genotrop should be avoided in patients with active malignancy, closed epiphyses, active proliferative/diabetic retinopathy, or hypersensitivity. Caution should be used in patients with diabetes mellitus, intracranial hypertension, or runaway growth disorders. The lowest effective dose should be utilized to minimize adverse effects. Concurrent glucocorticoid therapy requires careful monitoring due to potential growth inhibition. Genotrop therapy should be discontinued if epiphyseal closure occurs or if therapeutic goals have been achieved.
How does Genotrop differ from other somatropin products?
As a recombinant product, Genotrop has a lower risk of pathogen transmission compared to older pituitary-derived growth hormones. It also utilizes a modified protein sequence for greater stability. However, there are over a dozen somatropin products available, and they differ mainly in their manufacturing processes, inactive ingredients, and delivery devices. There is little high-quality evidence showing major differences in efficacy or safety between products when dosed appropriately. Formulary availability and patient preference for device typically drive product selection.
In summary, Genotrop provides exogenous growth hormone for treatment of clinically significant growth disturbances. Under proper physician supervision, it offers an effective means to promote growth and counter complications of growth hormone deficiency. Careful dosing, monitoring, and follow-up are essential to minimize adverse effects and ensure optimal therapeutic outcomes.
