From fixed to individual dosing in growth hormone-deficient adults

Initial research studies of growth hormone (GH) replacement in adults employed what is now considered to be high doses of GH, from 12 to 25 microg/kg per day. While the beneficial effects of GH were demonstrated, there was a considerable incidence of side effects, most commonly edema and arthralgia. These side effects abated with a dose reduction. More recently, the Growth Hormone Research Society recommended initiating GH replacement at a dose of 0.3 mg/day irrespective of total or ideal body weight. The United States Food and Drug Administration approved pharmaceutical company package inserts that recommended beginning with a dose of 6 microg/kg per day with a maximum dose of 25 microg/kg per day and limiting the maximal dose to 12.5 microg/kg per day in adults over the age of 35 years. These should be considered as guidelines.