From the FDA Drug Label
Glucocorticoids Clinical Impact: Microsomal enzyme 11β-hydroxysteroid dehydrogenase type 1 (11βHSD-1) is required for conversion of cortisone to its active metabolite, cortisol, in hepatic and adipose tissue. NORDITROPIN inhibits 11βHSD-1 Consequently, individuals with untreated GH deficiency have relative increases in 11βHSD-1 and serum cortisol. Initiation of NORDITROPIN may result in inhibition of 11βHSD-1 and reduced serum cortisol concentrations Intervention: Patients treated with glucocorticoid replacement for hypoadrenalism may require an increase in their maintenance or stress doses following initiation of NORDITROPIN [see Warnings and Precautions (5. 8)]. Examples: Cortisone acetate and prednisone may be effected more than others since conversion of these drugs to their biologically active metabolites is dependent on the activity of 11βHSD-1 Pharmacologic Glucocorticoid Therapy and Supraphysiologic Glucocorticoid Treatment Clinical Impact: Pharmacologic glucocorticoid therapy and supraphysiologic glucocorticoid treatment may attenuate the growth promoting effects of NORDITROPIN in pediatric patients Intervention: Carefully adjust glucocorticoid replacement dosing in pediatric patients receiving glucocorticoid treatments to avoid both hypoadrenalism and an inhibitory effect on growth.
The use of Norditropin and prednisone together requires careful consideration of the potential interactions between these two medications.
- Key considerations include the potential for Norditropin to inhibit the conversion of prednisone to its active metabolite, which may affect the efficacy of prednisone.
- Patients treated with glucocorticoid replacement for hypoadrenalism may require an increase in their maintenance or stress doses following initiation of Norditropin.
- Pharmacologic glucocorticoid therapy and supraphysiologic glucocorticoid treatment may attenuate the growth promoting effects of Norditropin in pediatric patients. It is essential to carefully adjust glucocorticoid replacement dosing in pediatric patients receiving glucocorticoid treatments to avoid both hypoadrenalism and an inhibitory effect on growth 1.
From the Research
Using Norditropin (somatropin) and prednisone together requires careful medical supervision due to their potentially opposing effects, and the most recent evidence suggests that close monitoring of glucose metabolism and bone health is crucial. Prednisone, a corticosteroid, can inhibit growth hormone's effectiveness, potentially reducing the therapeutic benefits of Norditropin, as noted in studies on the effects of corticosteroids on growth hormone therapy 2. This interaction is particularly concerning in children being treated for growth disorders, as prednisone may counteract growth promotion. Patients should be aware that prednisone can cause insulin resistance and elevated blood glucose, while Norditropin can also affect glucose metabolism, potentially compounding the risk of hyperglycemia, as discussed in the context of somatropin therapy 3. Regular monitoring of blood glucose levels is essential when using these medications concurrently. Additionally, both medications can affect bone metabolism - prednisone may reduce bone density while Norditropin typically supports bone health, highlighting the need for careful management to prevent osteoporosis, as emphasized in research on the effects of corticosteroids on bone health 2, 4. Dose adjustments of Norditropin may be necessary when starting, changing doses of, or discontinuing prednisone therapy. Patients should never adjust either medication without medical guidance and should report any unusual side effects promptly to their healthcare provider. The specific dosing and monitoring requirements should be individualized based on the patient's condition, age, and treatment goals, considering the potential for significant side effects from long-term corticosteroid use, as outlined in studies on the side effects of corticosteroid therapy 5, 4.
Some key considerations when using Norditropin and prednisone together include:
- Monitoring for signs of hyperglycemia and adjusting treatment as necessary
- Regular assessments of bone density to mitigate the risk of osteoporosis
- Close observation for any adverse effects related to either medication, such as changes in mental status, gastrointestinal issues, or hematologic abnormalities
- Adjusting doses based on clinical response and laboratory findings, such as serum insulin-like growth factor-1 concentration
- Ensuring patients are aware of the potential for drug interactions and the importance of adherence to prescribed treatment regimens.
Given the potential for significant interactions and the need for careful monitoring, the use of Norditropin and prednisone together should be approached with caution, and patients should be closely supervised by a healthcare provider experienced in managing growth hormone therapy and corticosteroid use.