Growth hormone (GH), also known as somatropin, plays a fundamental role in stimulating growth and regulating metabolism. When a deficiency is diagnosed, synthetic GH is prescribed to treat conditions like pediatric growth failure or adult GH deficiency. The standard method of administration is subcutaneous injection. This guide outlines the process, but it must supplement the hands-on training received from a medical professional. Adherence to a sterile procedure and the exact dosing prescribed by your physician is necessary to ensure the effectiveness and safety of the treatment.
Preparing Supplies and Reconstituting the Hormone
The injection process begins by gathering all necessary supplies. These typically include the powdered GH vial, sterile diluent (such as bacteriostatic water or saline), mixing and administration syringes, alcohol wipes, and a sharps container. Thorough handwashing with soap and water is required before handling any components. Wipe the rubber stoppers of both the GH vial and the diluent vial with a fresh alcohol swab and allow them to air-dry completely.
The next step is reconstituting the GH powder with the liquid diluent, which must be done gently to preserve the hormone’s structure. Use the mixing syringe to slowly inject the prescribed amount of diluent into the GH vial, aiming the stream against the inside glass wall. Swirl the vial with a gentle, rotary motion until the powder is fully dissolved and the solution appears clear. Vigorously shaking the vial can denature the protein and render the medication ineffective, so this must be avoided.
Inspect the clear solution for any cloudiness or solid particles, which indicate improper mixing; if present, the vial should not be used. If the GH was refrigerated, allowing it to warm slightly to room temperature before injection can reduce discomfort. Before drawing the dose, draw an equivalent amount of air into the administration syringe and inject it into the vial to equalize the pressure. This makes it easier to pull the correct volume of liquid GH into the syringe.
The Step-by-Step Injection Technique
The hormone is delivered into the subcutaneous fat layer. Common injection areas include the abdomen, the outer thigh, and the upper arm. The chosen site must be free of scars, bruises, or infection to ensure proper absorption and minimize discomfort.
Meticulous rotation of injection sites is necessary for a long-term GH regimen. Repeated use of the same location can cause lipoatrophy (fat tissue wasting) or lipohypertrophy (a firm fat lump). Both conditions negatively impact hormone absorption. Choose a new spot for the next injection that is at least one inch away from the previous one.
Clean the chosen location with a new alcohol wipe, moving in an outward spiral motion, and let the area dry completely. Gently pinch the skin between your thumb and forefinger to create a firm fold of fatty tissue. Holding the syringe like a dart, quickly insert the needle into the pinched skin fold.
The angle of insertion depends on the needle length and the amount of fat tissue. For most short needles (4mm or 5mm), a 90-degree angle straight into the skin is recommended. A 45-degree angle may be used for longer needles or in very thin individuals. Once the needle is fully inserted, slowly and steadily depress the plunger until the full dose is delivered. Rushing the administration increases discomfort and the chance of leakage.
Wait a few seconds after injection before withdrawing the needle straight out. Apply light pressure to the site with a cotton ball or gauze to stop any minor bleeding. Avoid rubbing the area, as this can push the hormone out of the injection site or cause irritation.
Post-Injection Safety and Sharps Disposal
Immediately following the injection, the used needle and syringe must be disposed of properly to prevent accidental needle-stick injuries. Place the entire assembly into a designated, hard-walled, puncture-resistant sharps container. Never attempt to recap, bend, or break the used needle before disposal, as this is the most common cause of injury.
Keep the sharps container in a safe location, out of the reach of children and pets. When the container reaches the fill line or is about three-quarters full, seal it securely. Disposal of the full container must follow local and state regulations, often requiring drop-off at a hospital, pharmacy, or authorized waste facility.
Proper storage of the remaining reconstituted GH is necessary to maintain potency. The mixed solution must be stored in a refrigerator, typically between 36°F to 46°F (2°C to 8°C). Depending on the formulation, reconstituted GH remains stable for 14 to 28 days. The medication should never be frozen, and any unused portion past its expiration date should be safely discarded.
Recognizing and Addressing Injection Concerns
Subcutaneous GH injections are usually well-tolerated. Minor, temporary side effects at the site are normal immediately following administration. These include slight redness, minor bruising, or a brief, localized stinging sensation, which resolve shortly after the injection.
The most significant long-term concern is lipoatrophy, which manifests as a noticeable depression or indentation in the skin. This is believed to be caused by the localized action of the growth hormone when injections are repeatedly given in the same small area. If you notice any fat wasting or firm lumps at an injection site, stop using that area immediately and report the finding to your prescribing physician.
Signs of a serious problem, such as a localized infection or severe allergic reaction, require prompt medical attention. Contact your doctor immediately if you develop fever, pain that worsens, increasing warmth or swelling around the injection site, or the presence of pus. Severe allergic reactions, though rare, are characterized by difficulty breathing or swelling of the face and throat, and these symptoms warrant calling emergency services.