Do not use the drug Norditropin Simplex, if the solution has ceased to be colorless and transparent.
Before use, make sure the cartridge is intact (for example, in the absence of cracks). Do not use the cartridge in the presence of any damage or cracks.
A specialist in the field of growth pathology should regularly monitor the condition of children receiving Norditropin Simplex.The treatment with Norditropin Simplex should always be started by a doctor who has special knowledge in the field of growth hormone deficiency and its treatment. This also applies to the treatment of growth retardation in the Shereshevsky-Turner syndrome and CRF.
Dysplasia in children with CRF should be accurately established before treatment with Norditropin Simplex is started by monitoring growth on optimal CRF therapy for one year. During therapy with the drug Norditropin Simplex, one should continue conservative treatment of uremia with traditional medicines and, if necessary, with dialysis.
During treatment Norditropin Simplex CRF patients renal function should be monitored for its pronounced decrease or improve the glomerular filtration rate (which may mean hyperfiltration).
The effect of somatropin on carbohydrate metabolism has been established, so patients should also be examined for glucose tolerance impairment.
In patients receiving insulin treatment, with the appointment of the drug Norditropin Simplex, it may be necessary to adjust its dose.
When treated with the drug Norditropin Simplex, the level of serum thyroxine may decrease due to increased peripheral deiodination of T4 in T3. In patients with progressive pathology of the pituitary gland, hypothyroidism may develop. Patients with Shereshevsky-Turner syndrome have an increased risk of developing primary hypothyroidism associated with anthyroiditis antibodies. Since hypothyroidism is an obstacle to an adequate rosive effect when treated with the drug Norditropin Simplex, patients receiving this therapy should regularly examine the thyroid function and conduct replacement therapy with thyroid hormones when it is detected.
With secondary growth hormone deficiency due to the presence of intracranial neoplasm, regular patient examinations should be performed to identify signs of progression or recurrence
primary disease. A small number of patients with growth hormone deficiency, some of whom were treated with somatropin, reported on the development of leukemia. Based on current data, it seems unlikely that the treatment with somatropin was the cause.In patients with complete remission of tumors or malignant diseases, growth hormone therapy was not associated with an increased rate of relapse. Nevertheless, after the start of Norditropin Simplex treatment, patients who achieved complete remission of malignant diseases should be carefully monitored for their relapse.
In patients with endocrine diseases, subluxation of the femoral head may be more common, and Legg-Calvet-Perthes disease may be more common in low-growth patients. These diseases can be manifested by lameness or pain in the femoral or knee joint. Doctors and patients should be warned about this.
In the presence of severe or repeated headaches, visual impairment, nausea and / or vomiting, it is recommended that the eye fundus (fundoscopy) be inspected to detect edema of the optic nerve disc. If the edema is confirmed, it is necessary to assume the presence of benign intracranial hypertension and, if this diagnosis is correct, treatment with growth hormone should be canceled. Currently, there is insufficient data to guide only the clinical criteria for deciding patients with intracranial hypertension in the resolution stage.When resuming treatment with growth hormone, careful monitoring of the symptoms of intracranial hypertension is necessary.
Adult drug Norditropin Simplex is prescribed for insufficiency of growth hormone, which developed in childhood and confirmed again during two provocative tests, as well as with a significant decrease in the production of growth hormone in the established disease of the hypothalamic-pituitary region (deficiency of another hormone other than prolactin), confirmed during two provocative tests after the initiation of adequate substitution treatment for the deficiency of any other hormone.
Adults with growth hormone deficiency undergoing substitution therapy with Norditropin Simplex should be under the supervision of an endocrinologist with experience in the treatment of pituitary diseases.
Adult growth hormone deficiency persists throughout life and requires appropriate treatment, but currently experience in treating patients older than 60 years, as well as the results of therapy lasting more than 5 years, are insufficient.