Growth Hormone Treatment

GH injections are quick and almost pain-free, so children ages 10 and up may be able to and often prefer to give themselves their own injections. It is important that a parent supervises the injection to make sure the child gives the correct dosage each day. Parents should give the injections to younger children. Because natural growth hormone is released mainly during sleep in children, GH treatment is more effective when taken at bedtime.

Learning how to give GH injections may sound intimidating at first, but once you and your child get used to it, it becomes just another daily habit. There are, however, some tips that you should know when you start GH therapy:

Storage

• GH must be refrigerated at 36 to 42° F; letting it get too hot or too cold will decrease its effectiveness.
• If left out overnight, you may place it back into refrigerator and continue to use it. 
• When traveling, keep it in the cooler provided in the starter kit for up to 10 hours, then put on ice after 10 hours. Be careful not to place GH pens directly in ice — keep them 
  separate by placing pen in a Ziploc bag.

Time of Day

• Give GH at night, preferably within an hour of sleep. Try to give it consistently within an hour timeframe, for example between 9 and 10 p.m. every night. 
• You may change the time occasionally, by a few hours earlier or later, but do not give before 5 p.m, except under unusual circumstances (such as leaving for a trip, a sleep-over, etc.)
• Do not make up missed injections. 
• For best results, try not to miss more than once per month.

Injection Sites

• Use 4 of the 8 possible injection sites, and rotate them each time. The sites are back of arms, top or outside of thighs, sides of belly, and outer quadrant of buttocks.
• Document the site used nightly on a calendar.
• Document when you open a new cartridge to keep track of expiration dates and how many injections have been used out of each cartridge.

Finishing A Cartridge

Because GH is very expensive, you should use up all of the medication in every cartridge.

• Pens will only allow you to dial to what is left of the medication. Use up the last of it, and start a new cartridge by doing a second injection with the amount missing.
• You may have to use up cartridges about once a week or so. If there is less than 0.2 mg left in the old cartridge, or if you are missing less than 0.2 mg of the last injection, do not give an additional injection.