Usual Pediatric Dose for
Up to 0.053 mg/kg subcutaneously once a day
Comments:
Generally, a dose of up to 0.47 mg/kg body weight per week is recommended.
The weekly dose should be divided over 6 or 7 days of subcutaneous injections.
Individualize dosage and administration schedule based on the growth response.
Serum insulin-like growth factor I (IGF-I) levels may be useful during dose titration.
Response to therapy in pediatric patients tends to decrease with time, however, failure to increase height velocity, particularly during the first year of treatment, should prompt close assessment of compliance and evaluation of other causes of poor growth, such as hypothyroidism, under-nutrition, advanced bone age, and antibodies to recombinant human growth hormone.
Treatment for short stature should be discontinued when the epiphyses are fused.
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Small for Gestational Age (SGA):
Up to 0.067 mg/kg subcutaneously daily
Short stature homeobox-containing gene (SHOX) deficiency:
0.05 mg/kg subcutaneously once a day (0.35 mg/kg per week in divided doses)
Comments:
The weekly dose should be divided over 6 or 7 days of subcutaneous injections.
SGA: Generally, a dose of up to 0.48 mg/kg body weight per week is recommended.
SGA: Recent literature recommends initial treatment with larger doses (e.g., 0.067 mg/kg once a day), especially in very short children (HSDS of lower than -3), and/or older/pubertal children.
SGA: In younger children (approximately less than 4 years, who respond the best in general) with less severe short stature (baseline HSDS values between -2 and -3), consider initiating treatment at a lower dose (0.033 mg/kg/day), and titrating the dose as needed over time.
Individualize dosage and administration schedule based on the growth response.
Serum insulin-like growth factor I (IGF-I) levels may be useful during dose titration.
Response to therapy in pediatric patients tends to decrease with time, however, failure to increase height velocity, particularly during the first year of treatment, should prompt close assessment of compliance and evaluation of other causes of poor growth, such as hypothyroidism, under-nutrition, advanced bone age, and antibodies to recombinant human growth hormone.
Treatment for short stature should be discontinued when the epiphyses are fused.