GHRH Ferring: Indications, Dosage, Precautions, Adverse Effects
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GHRH Ferring - Product Information

Manufacture: Ferring Pharmaceuticals
Country: Great Britain
Class: Growth hormones
Form: Intravenous (IV), Powder
Ingredients: somatorelin, sodium chloride, water for injection

Name of the Medicinal Product

GHRH Ferring, Powder and solvent for solution for injection 50µg

Qualitative and Quantitative Composition

Active Ingredient

Somatorelin as acetate, 50 micrograms per ampoule.

Pharmaceutical Form

Lyophilised powder for injection.

Sterile solution for reconstitution of an injectable preparation.

Clinical Particulars

Therapeutic indications

This medicinal product is for diagnostic use only.

GHRH is applied to determine the somatotropic function of the anterior pituitary gland in cases of suspected growth hormone deficiency. The test distinguishes between pituitary and hypothalamic disorders but is not suitable as a screening test for growth hormone deficiencies.

The diluent is supplied for the reconstitution of an injectable preparation.

Posology and method of administration

The recommended dosage for adult patients of standard weight is the content of one ampoule of GHRH Ferring (50 micrograms somatorelin) dissolved in 1ml of the supplied solvent. The solution is administered intravenously as a bolus injection.

In cases of highly overweight adult patients and in children, a dosage of 1 microgram per kg body weight is indicated.

GHRH Test: After withdrawal of approximately 2ml of venous blood from the fasted patient, the increase of basal growth hormone levels in plasma or serum after a single intravenous injection of the product is measured. For this procedure, the content of one ampoule is dissolved in 1ml of solvent (0.9% NaCl), or a volume corresponding to 1 microgram per kg body weight if appropriate, is administered intravenously to the fasted patient as a bolus injection (within 30 seconds).

To evaluate the growth hormone increment in plasma or serum, a second blood sample is taken 30 minutes after the injection. Peak growth hormone values may occasionally occur sooner or later. Therefore, additional blood samples may be taken 15, 45, 60 and 90 minutes after GHRH injection for better assessment of growth hormone release.

Contraindications

Hypersensitivity to somatorelin (human) acetate or to any of the excipients.

Special warnings and precautions for use

Because of the possible inhibitory influence of human growth hormone (hGH) on the somatotropic function of the pituitary gland the GHRH-test should not be carried out sooner than 1 week after discontinuation of treatment with human growth hormone.

The test results may be affected by the following conditions:

  • untreated hyper - and hypothyroidism
  • obesity, hyperglycaemia, elevated fatty acids
  • high level somatostatin

Interaction with other medicinal products and other forms of interaction

Concomitant use of substances influencing the release of growth hormone, such as growth hormone itself, as well as atropine, levodopa, dopamine, clonidine, arginine, ornithine. glycine, glucagon, insulin, oral glucose, thyreostatics and propranolol should be avoided. High levels of glucocorticoids as well as somatostatin or its analogues may inhibit the growth hormone release.

Fertility, pregnancy and lactation

In general, there is no indication for administration of somatorelin during pregnancy and lactation.

There are no adequate data from the use of GHRH Ferring in pregnant women.

Animal studies are insufficient with respect to effects on pregnancy. The potential risk for humans is unknown. Somatorelin should not be used during pregnancy unless clearly necessary.

There is insufficient information on the excretion of somatorelin in human or animal breast milk. The potential for adverse effects in the nursing infant from exposure to the drug is unknown. Somatorelin should not be used during lactation unless clearly necessary.

Effects on ability to drive and use machines

No studies on the effects on the ability to drive and use machines have been performed.

Due to the short duration of action of somatorelin the influence on the ability to drive and use machines is expected to be negligible.

Undesirable effects

MedDRA Organ ClassVery common ( ≥ 1/10)Common
( ≥ 1/100 to < 1/10)
Uncommon ( ≥ 1/1000 to < 1/100)Rare
( ≥ 1/10000 to < 1/1000)
Very rare
( < 1/10000)
Nervous system disorders Transient disturbances in sense of smell and taste   
Cardiac disorders Minor fluctuation in blood pressure*, Minor fluctuation in heart rate*   
Gastrointestinal disorders  Nausea, vomiting  
General disorders and administration site conditions Transient flushingInjection site pain, Chest tightness  

*In combination with flushing

As with all intravenous injections of peptides, anaphylactic reactions cannot be excluded.

Overdose

No case of overdose has been reported.

In case of overdose, the reported undesirable effects may occur (see section 4.8). Since somatorelin is eliminated rapidly from the body no measures in case of overdose are necessary.

Pharmacological properties

Pharmacodynamic properties

Pharmacotherapeutic group: Tests for pituitary function

ATC-code: V04CD05

Somatorelin is normally synthesised in the hypothalamus and stimulates the secretion of growth hormone from the pituitary gland. GHRH is the synthetic form of somatorelin and is identical in structure and function to somatorelin released by the human hypothalamus. Somatorelin physiologically increases plasma growth hormone levels.

Pharmacokinetic properties

After intravenous application of different doses of somatorelin in man, the concentrations of somatorelin in plasma increase within 5 minutes to the maximum value, followed by a rapid decrease. The basal values are reached again after 30-40 minutes.

Preclinical safety data

Not applicable.

Pharmaceutical particulars

List of excipients

Powder:

No excipients

Each diluent ampoule contains:

Sodium chloride Ph.Eur9mg
Water for injection to, Ph.Eur1.0ml

Incompatibilities

GHRH Ferring should not be administered together with other preparations for parenteral use (e.g. mixed injections or infusion solutions).

Shelf life

The Shelf life is 3 years.

GHRH should not be used after the expiry date printed on the package.

Special precautions for storage

Do not store above 25°C.

Nature and contents of container

GHRH Ferring is supplied in clear glass ampoules of high hydrolytic resistance (hydrolytic Class 1 according to Ph. Eur.).

The diluent is supplied in clear glass ampoules of high hydrolytic resistance (hydrolytic Class 1 according to Ph. Eur.).

Special precautions for disposal and other handling

Reconstitute GHRH Ferring with the solvent supplied, immediately prior to use.

Marketing authorisation holder

Ferring Pharmaceuticals Ltd

Drayton Hall

Church Road

West Drayton

UB7 7PS

Marketing authorisation number(s)

GHRH FerringPL 03194/0050
Diluent for GHRH FerringPL 03194/0051

Date of first authorisation/renewal of the authorisation

24th October 2008

Date of revision of the text

October 2012

Company contact details

Ferring Pharmaceuticals Ltd

http://www.ferring.co.uk

Address

Drayton Hall, Church Road, West Drayton, UB7 7PS, UK

Fax

+44 (0)844 931 0051

Telephone

+44 (0)844 931 0050

Medical Information e-mail

medical@ferring.com