Norditropin FlexPro 5 mg/1.5 ml solution for injection in pre-filled pen

Countries list updated (United Kingdom updated to United Kingdom (Northern Ireland))

Date of revision updated to 12/2022

Countries list updated (United Kingdom updated to United Kingdom (Northern Ireland))

Date of revision updated to 12/2022

Section 2:

'Somatropin' updated to 'somatropin' in 'somatropin (recombinant DNA origin produced in E-coli)'

Section 4.8 (table, Uncommon, Reproductive system and breast disorders):

'Gynecomastia' updated to 'Gynaecomastia'

Section 10:

Revision date updated to 12/2022.

Section 2 

Text added:

Norditropin contains sodium

Norditropin contains less than 1 mmol sodium (23 mg) per 1.5 ml, that is to say essentially ‘sodium-free’.

Section 6

Date of revision updated to: 05/2021

Section 4.4 Specials warnings and precautions for use

Text added:

Excipients
Norditropin contains less than 1 mmol sodium (23 mg) per 1.5 ml, that is to say essentially ‘sodium-free’.

Correction of minor spelling/typing errors throughout the text.

Section 4.4 Specials warnings and precautions for use

New text added:

Adults and Children
Pancreatitis
Although rare, pancreatitis should be considered in somatropin-treated patients who develop abdominal pain, especially in children.

Section 4.8 Undesirable effects

New text added to columns:

System organ classes

Reproductive system and breast disorders

Uncommon (≥ 1/1,000 to < 1/100)

In adults and children

Gynecomastia

Section 10. Date of revision of the text

Updated to: 05/2021

Section 2 - Warnings and precautions

New text added:

Norditropin FlexPro may cause an inflammation of the pancreas, which causes severe pain in the abdomen and back. Contact your doctor if you or your child develops stomach ache after taking Norditropin FlexPro.

Section 4 - Possible side effects

New text added regarding 'Breast enlargement (gynaecomastia) in the following sections:

Additional side effects in children

Uncommon (may affect up to 1 in 100 children)

- Breast enlargement (gynaecomastia)

Additional side effects in adults

Uncommon (may affect up to 1 in 100 children)

- Breast enlargement (gynaecomastia)

Section 6 - date of revision

Updated to: 02/2021

Section 1:

New indication added:

“If they have Noonan syndrome (a genetic problem which may affect growth).”

Section 3:

New text added:

“Children with Noonan syndrome:

The usual dose is 0.066 mg per kg body weight per day, however your doctor may decide that 0.033 mg per kg body weight per day is sufficient”

Section updated:

“How long you will need treatment for

•          Children with growth failure because of Turner syndrome, kidney disease, SGA or Noonan syndrome: Your doctor will recommend you continue treatment until you stop growing”

Section 4.1:

New indication added: “Growth failure due to Noonan syndrome”

Section 4.2:

New text added for new indication:

“Noonan syndrome:

0.066 mg/kg/day is the recommended dose, however in some cases 0.033 mg/kg/day may be sufficient (see section 5.1).

Treatment should be discontinued at the time of epiphyseal closure (see section 4.4).”

Section 4.4:

New text: “Traceability

In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.”

Section updated to:

“Children treated with somatropin should be regularly assessed by a specialist in child growth. Somatropin treatment should always be instigated by a physician with special knowledge of growth hormone insufficiency and its treatment. This is true also for the management of Turner syndrome, chronic renal disease, and SGA and Noonan syndrome. Data of final adult height following the use of Norditropin are limited for children with Noonan Syndrome and are not available for children with chronic renal disease are not available.”

Section updated to:

“Scoliosis is known to be more frequent in some of the patient groups treated with somatropin for example Turner syndrome and Noonan syndrome.”

Section 5.1:

Clinical efficacy and safety:

Full section update to include data related to the Noonan syndrome indication – see SPC for full details.

Section 2, Warnings and Precautions:

Deleted:

”If you develop a limp or low-back pain as these could be signs of a curved spine (scoliosis)”

Added:

• An increase in sideways curvature of the spine (scoliosis) may progress in any child during rapid growth. During treatment with Norditropin FlexPro, your doctor will check you (or your child) for signs of scoliosis.
• If you walk with a limp or if you start to limp during your growth hormone treatment, you should inform your doctor.

Section 5:

Sentence added: “Do not store close to any cooling elements.”

Change to storage instructions

IFU:

Sentence added: “Do not freeze your pen or store it close to any cooling element, e.g. in a refrigerator.”

Section 4.4:

Scoliosis

Scoliosis is known to be more frequent in some of the patient groups treated with somatropin for example Turner syndrome. In addition, rapid growth may progress in any child can cause progression of scoliosis. during rapid growth. Signs of scoliosis should be monitored during treatment. However, Somatropin treatment has not been shown to increase the incidence or severity of scoliosis. Signs of scoliosis should be monitored during treatment.

Slipped capital femoral epiphysis

In patients with endocrine disorders, including growth hormone deficiency, slipped epiphyses of the hip may occur more frequently than in the general population. A patient treated with somatropin who develops a limp or complains of hip or knee pain should be evaluated by a physician.

Section 4.8

• Sentence deleted from 'Post-marketing experience' (text updated and presented in Section 4.4):

Slipped capital femoral epiphysis. Slipped capital femoral epiphysis may occur more frequently in patients with endocrine disorders.

• HPRA reporting details condensed

Section 6.4

Sentence added: "Do not store close to any cooling elements."

Date of revision updated. No content change.