Somatropin side effects and risks

Reported side effects

• Swelling and fluid buildup: Adult GHD trials: peripheral swelling 17.5% GH vs 5.1% placebo at 6 months., moderate. Report new swelling; dose reduction often helps. New breathlessness needs urgent assessment. (source)
• Joint pain: Adult GHD: 17.3% GH vs 4.2% placebo. HIV wasting daily dose: 36.4% vs 11.3%., moderate. Report persistent pain and review the dose. (source)
• Hand tingling or numbness: Adult GHD: tingling 9.6% GH vs 1.9% placebo; carpal tunnel 2% in a 3031 person extension., moderate. Review dose and nerve symptoms promptly; weakness or persistent numbness needs assessment. (source)
• Headache: Adult GHD: 9.9% GH vs 7.7% placebo., mild. A severe headache with vomiting or vision changes needs urgent care. (source)
• Muscle pain: Adult GHD: 4.9% GH vs 1.6% placebo; HIV wasting daily dose: 30.4% vs 11.7%., moderate (source)
• High blood sugar or new diabetes: Adult extension: diabetes 12/3031, 0.4%; all had risk factors. Rates depend strongly on dose and population., serious. Check glucose and HbA1c; diabetes medicines may need adjustment. (source)
• Injection-site pain and local fat loss: Short bowel trial: injection site pain 31% GH alone vs 0% control. GHD injection site rates were not quantified., moderate. Rotate sites and review persistent redness, lumps or skin changes. (source)
• Fluid retention at short-bowel doses: Peripheral edema: 69% GH, 81% GH plus glutamine, 11% control; 16, 16 and 9 participants., moderate (source)
• Raised pressure around the brain: Reported with GH, usually within the first 8 weeks; an incidence rate is unavailable., serious. Stop and seek urgent assessment for headache with vomiting or vision change. (source)
• Severe allergic reaction: Anaphylaxis and angioedema have been reported after marketing; frequency cannot be estimated., serious. Stop and get emergency care for throat swelling, wheezing or trouble breathing. (source)
• Pancreatitis: Reported in children and adults; a reliable frequency is unavailable., serious. Get urgent care for severe ongoing upper belly pain or repeated vomiting. (source)
• Unmasked thyroid or adrenal deficiency: unknown, serious. Review free T4 and adrenal function, especially with known pituitary disease. (source)
• Hip growth-plate slip in children: unknown, serious. A new limp or hip or knee pain needs prompt assessment. (source)
• Second tumors in childhood cancer survivors: Risk is most relevant after prior head radiation. Active cancer is contraindicated., serious (source)

Stop and get help if

• Severe headache with vomiting, blurred vision or double vision: Stop GH and get urgent assessment for raised pressure around the brain.
• Throat or face swelling, wheezing or trouble breathing: Stop GH and get emergency care.
• Chest pain, fainting, sudden breathlessness or rapidly worsening swelling: Get emergency care.
• Severe ongoing upper belly pain, especially with repeated vomiting: Stop GH and seek urgent assessment for pancreatitis.
• Marked thirst or urination with vomiting, deep breathing or confusion: Get urgent care and check glucose; severe high blood sugar can be dangerous.
• Sweating, shaking, confusion or collapse while also using insulin: Check glucose promptly. Persistent symptoms, inability to swallow or unconsciousness need emergency care.
• Severe weakness, vomiting or fainting in someone with pituitary disease: Get urgent assessment for adrenal crisis and follow the prescribed adrenal emergency plan.
• A new limp, hip pain or knee pain in a child receiving GH: Seek prompt assessment for a slipped growth plate.

Who should avoid it

• activeCancer: Active cancer is a label contraindication. Any prior tumor must be inactive and its treatment completed before GH is considered.
• other: High-dose GH increased deaths after major surgery, trauma or acute respiratory failure. Acute critical illness is a label contraindication.
• diabeticRetinopathy: Active proliferative or severe nonproliferative diabetic retinopathy is contraindicated. Other retinopathy still needs clinician review.
• other: Known serious allergy to somatropin or this product’s ingredients is contraindicated.
• other: The Genotropin label contraindicates use for growth promotion in children with closed epiphyses (growth plates). This does not prohibit indicated growth-hormone replacement in adults with confirmed GH deficiency.
• pregnant: Human pregnancy data are insufficient to determine developmental risk.
• breastfeeding: The label reports limited milk data and no reported infant harm; safety evidence remains limited.
• tryingToConceive: Fertility add-on studies do not establish fetal safety or a washout interval.
• under18: Pediatric GH has specific approved growth-disorder uses that require specialist dosing and follow-up.
• cancerHistory: Prior cancer, head radiation or a pituitary tumor needs recurrence surveillance. Childhood cancer survivors can develop second tumors.
• diabetes: GH can reduce insulin sensitivity. Diabetes medicines may need adjustment; glucose should be monitored.
• surgeryPlanned: Discuss planned surgery. Safety of continuing replacement GH during acute critical illness has not been established.
• heartCondition: Fluid retention may matter more with heart disease. Review swelling, weight gain and breathlessness.
• uncontrolledBloodPressure: Fluid retention and rapid weight gain need review before GH exposure or dose escalation.
• kidneyDisease: Adult renal-impairment pharmacology data are limited. Childhood kidney-growth indications do not establish an adult dosing rule.
• liverDisease: Adult liver-impairment pharmacology studies are lacking for Genotropin; no standard dose adjustment is established.
• pancreatitisHistory: Pancreatitis has been reported. Review prior episodes and seek prompt care for new severe belly pain.
• sleepApnea: Review snoring or breathing pauses. In Prader-Willi syndrome, severe obesity or major breathing impairment can preclude GH.
• other: Severe obesity, prior upper-airway obstruction or sleep apnea, or severe breathing impairment in pediatric Prader-Willi syndrome is contraindicated.
• other: GH may uncover low cortisol or low thyroid hormone in people with pituitary disease. Replacement doses may need adjustment.
• testedAthlete: WADA prohibits GH at all times under S2.2.3, including use outside competition.

Interactions

• Insulin and other glucose-lowering drugs: GH can raise blood sugar and change drug needs. Insulin or sulfonylureas can cause low sugar if dose needs fall after GH is reduced or stopped.
• Glucocorticoids: GH may lower available cortisol and uncover adrenal insufficiency. Steroid replacement may need adjustment; excess steroids can blunt GH effects.
• Oral estrogen: Oral estrogen can lower the IGF-1 response and increase GH dose needs. Starting, stopping or changing estrogen route can alter the required dose.
• Thyroid hormone: GH may uncover central hypothyroidism. Free T4 and replacement dose may need review; extra thyroid hormone is not a routine GH add-on.
• CYP-metabolized medicines: Somatropin may alter clearance of CYP-metabolized drugs. The label advises monitoring; the size and direction of each interaction are uncertain.
• Other GH products or secretagogues: Duplicate GH exposure or adding release-stimulating drugs has no established healthy-adult benefit. Shared GH/IGF-1 effects may add risk.
• IGF-1 drugs: The cited bodybuilding regimens have no controlled safety evidence. Adding another growth signal does not establish greater benefit or safer glucose control.

Product quality risks

• FDA reports counterfeit and unapproved HGH entering the supply chain; an online vial or pen may not be a licensed product.
• A 2009 mass-spectrometry study found distinct oxidation, deamidation and chain-cleavage patterns in counterfeit and reference GH products.
• A 2025 analytical study detected GH in all 34 suspect products tested. Detection did not prove correct dose, sterility or clinical safety.
• Product identity and purity tests do not by themselves establish potency, freedom from endotoxin or sterility.
• An unknown vial’s storage history and mixing stability are unverified. Clear appearance cannot authenticate its contents.