Somatropin side effects: what 72,108 FDA adverse event reports show
Drug class
Recombinant human growth hormone
Brand names
Zomacton
Who reports
72,108 reports · 25% serious · 1,365 with death outcome · 40% female
Used for
ZOMACTON is a recombinant human growth hormone indicated for: Pediatric: Treatment of pediatric patients with growth failure due to inadequate secretion of endogenous growth hormone (GH), short stature associated with Turner syndrome, idiopathic short .
What it is
Somatropin is a human growth hormone (GH) produced by recombinant DNA technology using Escherichia coli. The protein is comprised of 191 amino acid residues and has a molecular weight of about 22,124 daltons. The amino acid sequence is identical to that of human growth hormone of pituitary origin.
Boxed warning
None in the current label
Causality screen of the 40 strongest signals
What the badges mean
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,128 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Device information output issue | 6,528 | 2,690.2 2,487.4–2,909.6ROR 2,954.2 · calibrated p 3e-23 ✓ | 256.2 EB05 251.0 · IC025 +7.9 3/3 methods agree | Reporting / coding artifact | serious n=97 · 84% consumer | not reported in cached trials |
| Device chemical property issue | 51 | 1,107.5 602.4–2,036.0ROR 1,108.2 · calibrated p 2e-15 ✓ | 208.2 EB05 164.5 · IC025 +5.7 3/3 methods agree | Reporting / coding artifact | 76% consumer | not reported in cached trials |
| Non-secretory adenoma of pituitary | 13 | 917.5 299.2–2,813.7ROR 917.6 · calibrated p 5e-11 ✓ | 164.7 EB05 102.4 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=13 | not reported in cached trials |
| Device calibration failure | 31 | 437.6 249.4–767.6ROR 437.7 · calibrated p 9e-12 ✓ | 155.8 EB05 115.0 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | 77% consumer | not reported in cached trials |
| Device mechanical issue | 7,685 | 429.5 414.8–444.7ROR 479.9 · calibrated p 9e-14 ✓ | 170.9 EB05 167.7 · IC025 +7.4 3/3 methods agree | Reporting / coding artifact | serious n=174 · 83% consumer | not reported in cached trials |
| Patient-device interaction issue | 16 | 410.6 190.6–884.7ROR 410.7 · calibrated p 2e-10 ✓ | 140.2 EB05 91.5 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | – | not reported in cached trials |
| Craniopharyngioma | 185 | 352.9 284.3–438.0ROR 353.8 · calibrated p 3e-12 ✓ | 154.9 EB05 137.0 · IC025 +6.5 3/3 methods agree | Not in label — unassessed | serious n=184 | NCT01088412: 19/21,177 (0.1%) on Somatropin (serious AE) |
| Device power source issue | 1,561 | 348.9 324.1–375.6ROR 356.5 · calibrated p 2e-12 ✓ | 156.3 EB05 149.9 · IC025 +7.1 3/3 methods agree | Reporting / coding artifact | serious n=22 · 81% consumer | not reported in cached trials |
| Expired device used | 1,448 | 229.9 214.6–246.3ROR 234.5 · calibrated p 1e-10 ✓ | 126.9 EB05 121.6 · IC025 +6.8 3/3 methods agree | Not in label — unassessed | serious n=81 · 82% consumer | not reported in cached trials |
| Insulin-like growth factor decreased | 216 | 197.3 165.9–234.8ROR 197.9 · calibrated p 6e-10 ✓ | 115.4 EB05 103.0 · IC025 +6.3 3/3 methods agree | Lab value / disease marker | serious n=48 | NCT01088412: 1/21,177 (0.0%) on Somatropin (serious AE) |
| Device user interface issue | 13 | 183.5 91.3–368.9ROR 183.5 · calibrated p 3e-8 ✓ | 96.2 EB05 59.9 · IC025 +3.5 3/3 methods agree | Reporting / coding artifact | – | not reported in cached trials |
| Device physical property issue | 2,902 | 182.7 174.5–191.3ROR 190.2 · calibrated p 6e-10 ✓ | 111.2 EB05 107.9 · IC025 +6.7 3/3 methods agree | Reporting / coding artifact | serious n=42 · 81% consumer | not reported in cached trials |
| Poor quality device used | 3,207 | 165.7 158.7–173.0ROR 173.3 · calibrated p 1e-9 ✓ | 104.7 EB05 101.7 · IC025 +6.6 3/3 methods agree | Not in label — unassessed | serious n=124 · 80% consumer | not reported in cached trials |
| Drug administered in wrong device | 345 | 161.5 141.5–184.3ROR 162.3 · calibrated p 3e-9 ✓ | 102.5 EB05 93.8 · IC025 +6.3 3/3 methods agree | Not in label — unassessed | serious n=55 · 81% consumer | not reported in cached trials |
| Epiphysiolysis | 89 | 160.0 123.4–207.5ROR 160.2 · calibrated p 5e-9 ✓ | 100.3 EB05 84.0 · IC025 +5.7 3/3 methods agree | Not in label — unassessed | serious n=86 | NCT01088412: 11/21,177 (0.1%) on Somatropin (serious AE) |
| Device material issue | 717 | 157.9 144.1–172.9ROR 159.4 · calibrated p 3e-9 ✓ | 101.3 EB05 95.3 · IC025 +6.4 3/3 methods agree | Reporting / coding artifact | serious n=11 · 75% consumer | not reported in cached trials |
| Glioneuronal tumour | 19 | 153.2 87.7–267.9ROR 153.3 · calibrated p 4e-8 ✓ | 90.8 EB05 61.5 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=19 | not reported in cached trials |
| Blood growth hormone decreased | 70 | 150.8 112.9–201.6ROR 151.0 · calibrated p 9e-9 ✓ | 96.1 EB05 78.7 · IC025 +5.5 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious n=21 · 74% consumer | not reported in cached trials |
| Circumstance or information capable of leading to device use error | 767 | 139.2 127.7–151.8ROR 140.7 · calibrated p 8e-9 ✓ | 93.4 EB05 87.9 · IC025 +6.3 3/3 methods agree | Not in label — unassessed | serious n=10 · 82% consumer | not reported in cached trials |
| Pituitary tumour recurrent | 56 | 136.3 99.1–187.5ROR 136.4 · calibrated p 2e-8 ✓ | 89.5 EB05 71.5 · IC025 +5.2 3/3 methods agree | Labeled (related wording) related wording | serious n=55 | NCT01088412: 1/21,177 (0.0%) on Somatropin (serious AE) |
| Device material opacification | 14 | 127.5 67.8–239.6ROR 127.5 · calibrated p 2e-7 ✓ | 79.0 EB05 50.0 · IC025 +3.6 3/3 methods agree | Reporting / coding artifact | – | not reported in cached trials |
| Insulin-like growth factor increased | 386 | 106.0 94.3–119.1ROR 106.6 · calibrated p 8e-8 ✓ | 77.1 EB05 70.8 · IC025 +6.0 3/3 methods agree | Lab value / disease marker | serious n=135 | NCT01088412: 1/21,177 (0.0%) on Somatropin (serious AE) |
| Septo-optic dysplasia | 18 | 105.9 61.6–182.0ROR 105.9 · calibrated p 5e-7 ✓ | 71.6 EB05 47.9 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=17 | not reported in cached trials |
| Wrong device used | 173 | 104.6 87.8–124.5ROR 104.8 · calibrated p 1e-7 ✓ | 76.0 EB05 66.9 · IC025 +5.7 3/3 methods agree | Reporting / coding artifact | serious n=32 · 79% consumer | not reported in cached trials |
| Device leakage | 10,550 | 95.4 93.4–97.4ROR 111.3 · calibrated p 5e-8 ✓ | 71.5 EB05 70.4 · IC025 +6.1 3/3 methods agree | Reporting / coding artifact | serious n=278 · 78% consumer | not reported in cached trials |
| Drug dose omission by device | 18,297 | 90.1 88.8–91.5ROR 119.9 · calibrated p 3e-8 ✓ | 68.6 EB05 67.7 · IC025 +6.1 3/3 methods agree | Not in label — unassessed | serious n=461 · 82% consumer | not reported in cached trials |
| Device breakage | 9,380 | 90.1 88.1–92.1ROR 103.2 · calibrated p 9e-8 ✓ | 68.5 EB05 67.4 · IC025 +6.1 3/3 methods agree | Reporting / coding artifact | serious PRR 8.3 · 79% consumer | not reported in cached trials |
| Germ cell cancer | 31 | 78.1 52.5–116.3ROR 78.2 · calibrated p 2e-6 ✓ | 59.3 EB05 43.8 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=31 · 100% clinician | NCT01088412: 1/12,692 (0.0%) on Somatropin (serious AE) |
| Inadvertent injection air bubble | 24 | 77.9 49.6–122.4ROR 77.9 · calibrated p 2e-6 ✓ | 58.5 EB05 41.4 · IC025 +4.1 3/3 methods agree | Not in label — unassessed | 100% consumer | not reported in cached trials |
| Adenoidal hypertrophy | 77 | 73.7 57.3–94.7ROR 73.8 · calibrated p 1e-6 ✓ | 57.8 EB05 47.8 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious n=74 · 91% clinician | NCT01088412: 5/21,177 (0.0%) on Somatropin (serious AE) |
| Product knowledge deficit | 111 | 70.4 57.2–86.7ROR 70.5 · calibrated p 2e-6 ✓ | 56.0 EB05 47.8 · IC025 +5.2 3/3 methods agree | Reporting / coding artifact | 89% consumer | not reported in cached trials |
| Product reconstitution quality issue | 166 | 68.2 57.6–80.8ROR 68.4 · calibrated p 2e-6 ✓ | 54.8 EB05 48.2 · IC025 +5.3 3/3 methods agree | Reporting / coding artifact | 72% consumer | not reported in cached trials |
| Blood 25-hydroxycholecalciferol decreased | 55 | 66.6 49.7–89.4ROR 66.7 · calibrated p 3e-6 ✓ | 53.2 EB05 42.4 · IC025 +4.7 3/3 methods agree | Lab value / disease marker | – | not reported in cached trials |
| Medulloblastoma recurrent | 21 | 64.4 40.1–103.5ROR 64.5 · calibrated p 8e-6 ✓ | 50.4 EB05 34.8 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious n=21 | NCT01088412: 4/21,177 (0.0%) on Somatropin (serious AE) |
| Osteochondroma | 22 | 64.0 40.3–101.7ROR 64.0 · calibrated p 8e-6 ✓ | 50.2 EB05 35.0 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=18 | NCT01088412: 1/21,177 (0.0%) on Somatropin (serious AE) |
| Medulloblastoma | 25 | 57.4 37.3–88.2ROR 57.4 · calibrated p 1e-5 ✓ | 46.3 EB05 33.0 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=25 · 100% clinician | NCT01088412: 1/21,177 (0.0%) on Somatropin (serious AE) |
| Hepatoblastoma | 16 | 55.8 32.6–95.3ROR 55.8 · calibrated p 2e-5 ✓ | 44.4 EB05 29.0 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=16 | not reported in cached trials |
| Device use issue | 2,779 | 54.8 52.7–57.1ROR 57.0 · calibrated p 6e-6 ✓ | 46.1 EB05 44.6 · IC025 +5.5 3/3 methods agree | Reporting / coding artifact | serious n=126 · 83% consumer | not reported in cached trials |
| Device electrical finding | 113 | 54.3 44.4–66.5ROR 54.4 · calibrated p 1e-5 ✓ | 45.4 EB05 38.8 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | 75% consumer | not reported in cached trials |
| Epiphyses premature fusion | 46 | 52.2 38.1–71.4ROR 52.2 · calibrated p 2e-5 ✓ | 43.4 EB05 33.9 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=44 | not reported in cached trials |
Trial evidence (ClinicalTrials.gov)
✓ Trial adverse-event data found on ClinicalTrials.gov
Largest completed trials with posted results that list Somatropin as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (10 of 40 signal terms matched).
- NCT01088412 — Observational Study of Somatropin Treatment in Children (N=22845, phase n/a; 517 AE terms posted; arms: Treated; Untreated; )
Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug dose omission by device | 18,297 | 90.1 88.8–91.5ROR 119.9 · calibrated p 3e-8 ✓ | 68.6 EB05 67.7 · IC025 +6.1 3/3 methods agree | Not in label — unassessed | serious n=461 · 82% consumer | not reported in cached trials |
| Device leakage | 10,550 | 95.4 93.4–97.4ROR 111.3 · calibrated p 5e-8 ✓ | 71.5 EB05 70.4 · IC025 +6.1 3/3 methods agree | Reporting / coding artifact | serious n=278 · 78% consumer | not reported in cached trials |
| Device breakage | 9,380 | 90.1 88.1–92.1ROR 103.2 · calibrated p 9e-8 ✓ | 68.5 EB05 67.4 · IC025 +6.1 3/3 methods agree | Reporting / coding artifact | serious PRR 8.3 · 79% consumer | not reported in cached trials |
| Device mechanical issue | 7,685 | 429.5 414.8–444.7ROR 479.9 · calibrated p 9e-14 ✓ | 170.9 EB05 167.7 · IC025 +7.4 3/3 methods agree | Reporting / coding artifact | serious n=174 · 83% consumer | not reported in cached trials |
| Device information output issue | 6,528 | 2,690.2 2,487.4–2,909.6ROR 2,954.2 · calibrated p 3e-23 ✓ | 256.2 EB05 251.0 · IC025 +7.9 3/3 methods agree | Reporting / coding artifact | serious n=97 · 84% consumer | not reported in cached trials |
| Device issue | 5,599 | 19.6 19.1–20.2ROR 21.2 · calibrated p 0.002 ✓ | 18.4 EB05 18.0 · IC025 +4.2 3/3 methods agree | Reporting / coding artifact | serious PRR 9.9 · 80% consumer | not reported in cached trials |
| Wrong technique in device usage process | 4,961 | 34.9 33.9–35.9ROR 37.3 · calibrated p 8e-5 ✓ | 31.1 EB05 30.4 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | serious n=272 · 78% consumer | not reported in cached trials |
| Injection site pain (pain where injected) | 3,677 | 3.5 3.4–3.6ROR 3.6 · calibrated p 0.451 | 3.5 EB05 3.4 · IC025 +1.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 6.2 · 78% consumer | NCT01088412: 4/21,177 (0.0%) on Somatropin (serious AE) |
| Device use error | 3,278 | 30.5 29.4–31.6ROR 31.9 · calibrated p 2e-4 ✓ | 27.6 EB05 26.8 · IC025 +4.7 3/3 methods agree | Reporting / coding artifact | serious n=87 · 81% consumer | not reported in cached trials |
| Poor quality device used | 3,207 | 165.7 158.7–173.0ROR 173.3 · calibrated p 1e-9 ✓ | 104.7 EB05 101.7 · IC025 +6.6 3/3 methods agree | Not in label — unassessed | serious n=124 · 80% consumer | not reported in cached trials |
| Device physical property issue | 2,902 | 182.7 174.5–191.3ROR 190.2 · calibrated p 6e-10 ✓ | 111.2 EB05 107.9 · IC025 +6.7 3/3 methods agree | Reporting / coding artifact | serious n=42 · 81% consumer | not reported in cached trials |
| Incorrect dose administered | 2,793 | 3.6 3.5–3.7ROR 3.7 · calibrated p 0.438 | 3.6 EB05 3.5 · IC025 +1.8 3/3 methods agree | Reporting / coding artifact | serious PRR 3.7 · 78% consumer | not reported in cached trials |
| Incorrect dose administered by device | 2,779 | 35.2 33.9–36.6ROR 36.6 · calibrated p 9e-5 ✓ | 31.4 EB05 30.4 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | serious n=184 · 80% consumer | not reported in cached trials |
| Device use issue | 2,779 | 54.8 52.7–57.1ROR 57.0 · calibrated p 6e-6 ✓ | 46.1 EB05 44.6 · IC025 +5.5 3/3 methods agree | Reporting / coding artifact | serious n=126 · 83% consumer | not reported in cached trials |
| Device delivery system issue | 2,354 | 28.4 27.2–29.6ROR 29.3 · calibrated p 3e-4 ✓ | 25.9 EB05 25.0 · IC025 +4.6 3/3 methods agree | Reporting / coding artifact | serious n=98 · 80% consumer | not reported in cached trials |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Craniopharyngioma — n=185, PRR 352.9 (also seen in trial arm)
- Expired device used — n=1,448, PRR 229.9
- Poor quality device used — n=3,207, PRR 165.7
- Drug administered in wrong device — n=345, PRR 161.5
- Epiphysiolysis — n=89, PRR 160.0 (also seen in trial arm)
- Circumstance or information capable of leading to device use error — n=767, PRR 139.2
- Drug dose omission by device — n=18,297, PRR 90.1
- Germ cell cancer — n=31, PRR 78.1 (also seen in trial arm)
- Inadvertent injection air bubble — n=24, PRR 77.9
- Adenoidal hypertrophy — n=77, PRR 73.7 (also seen in trial arm)
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Somatropin?
In FDA FAERS, the most frequently co-reported reaction terms for Somatropin are drug dose omission by device, injection site pain, poor quality device used. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Somatropin have an FDA boxed warning?
No. The FDA label retrieved for Somatropin has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Somatropin causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 85ba081b-bee0-4a9a-aa0f-ae5b5e9a0886, effective 20260420; matched on
openfda.generic_name.exact:"SOMATROPIN") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,168 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
SOMATROPIN, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.