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What is a growth disorder?

Every child experiences growth at a different rate. While many factors can affect growth, some children may have a medical condition known as a growth disorder. Growth disorders can hinder your child from developing normal height, weight, sexual maturity, or other characteristics.1

What is growth hormone
deficiency (GHD)?

GHD is one of many growth disorders that a child can be born with, or can develop over time. The body’s pituitary gland produces somatropin, which is a growth hormone that helps the body develop into adulthood. When a child does not produce enough somatropin for normal development,
they can have a growth hormone deficiency.2-5

Congenital GHD

“Congenital GHD” means that a child was born with GHD. This is typically caused by a genetic mutation (change) or structural issue during brain development.7

Acquired GHD

“Acquired GHD” means the condition developed after birth as a result of damage to the pituitary gland. Children and adults can have acquired GHD.7

Idiopathic GHD

“Idiopathic” is a medical term that suggests there is no known cause. Some cases of GHD have an unknown cause.7

GHD can also occur in adults

Growth hormone plays an important role in bone health, muscle growth, and keeping the metabolism in balance. When adults are deficient in growth hormone, they can also experience changes in cholesterol levels and glucose metabolism.8

GHD in adults is commonly “acquired” and is typically a result of damage to the pituitary gland and/or hypothalamus from an accident or trauma (for example,
a head injury, surgery, or radiation treatment). The most common cause of Adult GHD is a pituitary tumor, which leads to low or no production of growth hormone.8

Adults with growth hormone deficiency may benefit from treatment with ZOMACTON.9

Diagnosing GHD in children

Diagnosis of GHD in children most often occurs within two age ranges. The first range begins around the age of 5,
when children begin school and parents can more easily compare their child’s height to other classmates. The
second is during their early teens since a delay in puberty can signal suspicion of GHD.7

GHD is diagnosed by using different tests, including7:

  • An assessment of the child’s medical and growth history
  • Lab tests to rule out other causes of short height
  • A blood test that measures growth hormone levels
  • MRI (image test) of the child’s pituitary gland or brain

What are some other
causes of growth failure?

GHD is just one reason some children experience slow or
no growth. There are many other medical conditions
that may also cause short stature in children. Here are a few, which ZOMACTON can treat. Individual results may vary.9
Short stature associated with Turner syndrome
Idiopathic short stature (ISS)
Short stature or growth failure in short stature
homeobox-containing gene (SHOX) deficiency
Small for Gestational Age (SGA) and have
not caught up in growth by age 2-4 years old

What is Turner syndrome?

Turner syndrome occurs in 25-50 per 100,000 females, affecting females with one intact chromosome and complete or partial absence of the second sex chromosome in association with one or more clinical features. However, while some girls may have many physical differences and certain health problems, others may have few.10,11

Idiopathic short stature (ISS)

In ISS, the reason for a child’s short stature is unknown. Children with ISS are significantly shorter than 98.8% of other children of the same age and gender. However, there may be no detected medical reason for slowing growth.12

What is SHOX deficiency?

SHOX deficiency is a genetic disorder that is a common cause of short stature in children. SHOX is an important growth gene located on the X and Y chromosomes that plays a role in short stature in humans if the gene is mutated. In SHOX deficiency, short stature is mainly characterized by shortening of the extremities and can also be associated with Turner syndrome, Leri-Weill syndrome, and some cases of ISS.13

What is SGA?

SGA is a term used for babies who are born with a birth weight below the 3rd percentile, which means that they are smaller than most other babies born after the same number of weeks of gestation (time in womb). There are many factors that can lead to SGA, with up to 10% of live births being diagnosed with this condition. One of 10 children fail to achieve catch-up growth by age 2 and are often referred to as “short SGA.”14

Know when to see a doctor

Growth increments are the most important criteria in the diagnosis of GHD in children. The main sign of GHD in children is growth of less than 2 inches in height per year after a child’s third birthday.2,7

In addition to changes in growth, be aware of the signs listed below.
If you see them, seek the opinion of your pediatrician or a specialist,
such as a pediatric endocrinologist. Your child’s growth journey is unique. Beginning treatment early in their development period can help them achieve their full potential.

  • Slowed growth in height
  • Short stature
  • Young-looking face
  • Delayed tooth development
  • Delayed puberty
  • Low blood sugar levels (infants and toddlers)

Evaluating your child’s growth

Monitoring your child’s growth patterns is important for early identification of potential developmental issues.
You can do this by regularly measuring their length or height and comparing it to standard child growth trends recorded by the World Health Organization. Most children fall between
the 15th and 85th percentiles.

Birth-2 years of age

2-5 years of age

Questions to ask your doctor:

Should I be worried about my child’s height?
What tests show if there’s a growth deficiency?
What can I do about a possible growth deficiency?
What treatments are available?
How could my child’s growth be affected?
Where can I get more information and support?

Helpful resources

An organization providing advocacy, education, and support for children and adults with endocrine disorders.

A group focused on helping people access quality genetic services that are needed for comprehensive healthcare.

A patient advocacy organization dedicated to people with rare diseases and the groups that support them.

A nonprofit, voluntary organization dedicated to helping children and adults with growth disorders.

References: 1. MedlinePlus. Growth disorders. Accessed May 31, 2024. https://medlineplus.gov/growthdisorders.html 2. Endocrine Society. Growth hormone deficiency. Accessed October 16, 2024. https://www.endocrine.org/patient-engagement/endocrine-library/growth-hormone-deficiency 3. Nemours Children’s Health. Endocrine system. Accessed May 31, 2024. http://kidshealth.org/en/teens/endocrine.html# 4. Reh CS, Geffner ME. Somatropin in the treatment of growth hormone deficiency and Turner Syndrome in pediatric patients: a review. Clin Pharmacol. 2019;2:111-122. doi:10.2147/CPAA.S6525 5. John’s Hopkins Medicine. Growth hormone deficiency. Accessed May 31, 2024. https://www.hopkinsmedicine.org/health/ conditions-and-diseases/growth-hormone-deficiency 6. US Census Bureau 2020 Population Estimates. 7. Cleveland Clinic. Growth hormone deficiency(GHD). Accessed July 17, 2024. https://my.clevelandclinic.org/health/diseases/23343-growth-hormone-deficiency-ghd 8. The MAGIC Foundation. Endocrine Disorders. Accessed October 16, 2024. https://www.magicfoundation.org/growth-hormone-deficiency-in-adults 9. ZOMACTON [Prescribing Information]. Parsippany, NJ: Ferring Pharmaceuticals Inc. 10. Turner Syndrome Society of the United States. Accessed October 15, 2025. https://www.turnersyndrome.org/_files/ugd/ff2c76_61e89cc2e343435488b65087e63721c0.pdf 11. The MAGIC Foundation. Turner syndrome. Accessed November 12, 2018. https://www.magicfoundation.org/Growth-Disorders/Turner-Syndrome/ 12. The MAGIC Foundation. Idiopathic short stature. Accessed October 16, 2024. https://www.magicfoundation.org/idiopathic-short-stature 13. Leka SK, Kitsiou-Tzeli S, Kalpini-Mavrou A, Kanavakis E. Short stature and dysmorphology associated with defects in the SHOX gene. Hormones. 2006;5(2):107-118. 14. The MAGIC Foundation. Small for gestational age. Accessed November 12, 2018. https://www.magicfoundation.org/Growth-Disorders/Small-for-Gestational-Age/

ZOMACTON (somatropin) for Injection

IMPORTANT SAFETY INFORMATION

Indication

ZOMACTON is a prescription medicine that contains human growth hormone and is used to treat pediatric patients who:

  • are not growing because they do not make enough growth hormone on their own
  • have short stature associated with Turner syndrome
  • have Idiopathic Short Stature
  • have short stature or growth failure in short stature homeobox-containing gene (SHOX) deficiency
  • are short stature born small (small for gestational age-SGA) and have not caught up in growth by age 2 to 4 years old

ZOMACTON is also used for adults who do not make enough growth hormone on their own.

Important Safety Information

WHO SHOULD NOT TAKE ZOMACTON?

ZOMACTON is not for:

  • Patients who have acute critical illness after open heart or abdominal surgery, multiple accidental trauma, or those with respiratory failure due to risk of death
  • Pediatric patients with Prader-Willi syndrome who are severely overweight, have sleep apnea or a history of or existing severe breathing problems due to the risk of death
  • Patients who have active cancer
  • Patients who are allergic to any of the ingredients provided with ZOMACTON
  • Patients with severe visual problems caused by diabetes
  • Pediatric patients whose growth plates have closed

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT ZOMACTON?

  • If you have or had cancer as a child, there is an increased risk of getting another tumor. Patients with prior tumors should be monitored for development or recurrence
  • ZOMACTON may decrease insulin sensitivity. Your doctor should check your blood sugar regularly, especially if you have diabetes, pre-diabetes, or risk factors for diabetes
  • Increased pressure in the brain has occurred. Tell your doctor if you have any visual changes, headache, nausea, and/or vomiting. You may need to stop treatment. Routine eye exams should be performed
  • Serious allergic reactions may occur. Seek prompt medical attention
  • Water retention during treatment may occur in adults and may be dose dependent
  • Your doctor may need to monitor changes in your blood levels and adjust the dose of your medication if you have hypoadrenalism and are on glucocorticoid replacement therapy
  • Thyroid function should be checked periodically. Thyroid hormone replacement may be needed or adjusted after starting on ZOMACTON
  • A fracture in the ball of the hip joint can occur in pediatric patients. Tell your doctor if a limp develops or you have hip or knee pain
  • Progression of preexisting scoliosis can occur and should be monitored
  • Pancreatitis has been reported. Tell your doctor if you are having abdominal pain especially if you are a pediatric patient
  • ZOMACTON 5 mg comes with a liquid vial (diluent) that contains benzyl alcohol which can cause serious and fatal reactions to a newborn or an infant. Mix with normal saline, instead of the diluent containing benzyl alcohol, when administering to newborns or infants
  • Your doctor may adjust the dose of ZOMACTON or of other medications that you are taking
  • If ZOMACTON 5 mg is needed while pregnant or nursing, it should be mixed with normal saline or use ZOMACTON 10 mg which contains a benzyl alcohol-free formulation

WHAT ARE THE POSSIBLE SIDE EFFECTS OF ZOMACTON?

The most common side effects reported include upper respiratory infection, fever, sore throat (pharyngitis), headache, earache (otitis media), swollen hands/feet or ankles (edema), joint or muscle pain/discomfort (arthralgia, paresthesia, myalgia), carpal tunnel syndrome, accumulation of fluid causing swelling (peripheral edema), flu syndrome, hypothyroidism, hyperglycemia, and diabetes.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 800-FDA-1088.

HOW SHOULD I STORE ZOMACTON?

ZOMACTON must be kept refrigerated (36° to 46°F [2° to 8°C]). DO NOT FREEZE. After mixing with liquid, ZOMACTON 5 mg must be used within 14 days and ZOMACTON 10 mg must be used within 28 days. Do not use medication if it is expired or cloudy.

Please see Full Prescribing Information for ZOMACTON.

ZOMACTON (somatropin) for Injection

IMPORTANT SAFETY INFORMATION

Indication

ZOMACTON is a prescription medicine that contains human growth hormone and is used to treat pediatric patients who:

  • are not growing because they do not make enough growth hormone on their own
  • have short stature associated with Turner syndrome
  • have Idiopathic Short Stature
  • have short stature or growth failure in short stature homeobox-containing gene (SHOX) deficiency
  • are short stature born small (small for gestational age-SGA) and have not caught up in growth by age 2 to 4 years old

ZOMACTON is also used for adults who do not make enough growth hormone on their own.

Important Safety Information

WHO SHOULD NOT TAKE ZOMACTON?

ZOMACTON is not for:

  • Patients who have acute critical illness after open heart or abdominal surgery, multiple accidental trauma, or those with respiratory failure due to risk of death
  • Pediatric patients with Prader-Willi syndrome who are severely overweight, have sleep apnea or a history of or existing severe breathing problems due to the risk of death
  • Patients who have active cancer
  • Patients who are allergic to any of the ingredients provided with ZOMACTON
  • Patients with severe visual problems caused by diabetes
  • Pediatric patients whose growth plates have closed

WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT ZOMACTON?

  • If you have or had cancer as a child, there is an increased risk of getting another tumor. Patients with prior tumors should be monitored for development or recurrence
  • ZOMACTON may decrease insulin sensitivity. Your doctor should check your blood sugar regularly, especially if you have diabetes, pre-diabetes, or risk factors for diabetes
  • Increased pressure in the brain has occurred. Tell your doctor if you have any visual changes, headache, nausea, and/or vomiting. You may need to stop treatment. Routine eye exams should be performed
  • Serious allergic reactions may occur. Seek prompt medical attention
  • Water retention during treatment may occur in adults and may be dose dependent
  • Your doctor may need to monitor changes in your blood levels and adjust the dose of your medication if you have hypoadrenalism and are on glucocorticoid replacement therapy
  • Thyroid function should be checked periodically. Thyroid hormone replacement may be needed or adjusted after starting on ZOMACTON
  • A fracture in the ball of the hip joint can occur in pediatric patients. Tell your doctor if a limp develops or you have hip or knee pain
  • Progression of preexisting scoliosis can occur and should be monitored
  • Pancreatitis has been reported. Tell your doctor if you are having abdominal pain especially if you are a pediatric patient
  • ZOMACTON 5 mg comes with a liquid vial (diluent) that contains benzyl alcohol which can cause serious and fatal reactions to a newborn or an infant. Mix with normal saline, instead of the diluent containing benzyl alcohol, when administering to newborns or infants
  • Your doctor may adjust the dose of ZOMACTON or of other medications that you are taking
  • If ZOMACTON 5 mg is needed while pregnant or nursing, it should be mixed with normal saline or use ZOMACTON 10 mg which contains a benzyl alcohol-free formulation

WHAT ARE THE POSSIBLE SIDE EFFECTS OF ZOMACTON?

The most common side effects reported include upper respiratory infection, fever, sore throat (pharyngitis), headache, earache (otitis media), swollen hands/feet or ankles (edema), joint or muscle pain/discomfort (arthralgia, paresthesia, myalgia), carpal tunnel syndrome, accumulation of fluid causing swelling (peripheral edema), flu syndrome, hypothyroidism, hyperglycemia, and diabetes.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 800-FDA-1088.

HOW SHOULD I STORE ZOMACTON?

ZOMACTON must be kept refrigerated (36° to 46°F [2° to 8°C]). DO NOT FREEZE. After mixing with liquid, ZOMACTON 5 mg must be used within 14 days and ZOMACTON 10 mg must be used within 28 days. Do not use medication if it is expired or cloudy.

Please see Full Prescribing Information for ZOMACTON.