Contraindications
Hypersensitivity Reactions
Sermorelin is contraindicated in patients with a known hypersensitivity to sermorelin acetate or any excipients in the formulation. Allergic reactions may manifest as hives, rash, or anaphylaxis requiring immediate discontinuation and medical intervention.[11]
Active Malignancies
Tesamorelin, a medication that also stimulates GHRH receptors, is contraindicated in patients with active or recurrent malignancies due to its potential to elevate insulin-like growth factor 1 (IGF-1), which may stimulate tumor growth. [8] Sermorelin may increase IGF-1, which may pose a risk in this patient population.[2][8]
Pregnancy and Lactation
Sermorelin is classified under *Pregnancy Category C*, as animal studies have shown fetal variations at high doses.[9]
Human data is insufficient, and the risks to fetal development remain uncertain. Sermorelin should also be avoided in breastfeeding patients, as its excretion in human milk is unknown.[1][9][10]
Hypothalamic-Pituitary Axis Disruption
Patients with structural hypothalamic or pituitary abnormalities (e.g., tumors, post-surgical damage, or hypophysectomy) are not candidates for medications classified as growth hormone-releasing agonists. These drugs require an intact pituitary gland to stimulate growth hormone (GH) secretion.[8] [11]
Untreated Hypothyroidism
Untreated hypothyroidism may impair sermorelin’s potential.[1][8]
Precautions
Thyroid Function
Regular monitoring of thyroid function is needed, as untreated hypothyroidism may compromise potential response.[1][9]
Drug Interactions
Sermorelin may interact with other medications including glucocorticoids (e.g., prednisone), cyclooxygenase inhibitors (e.g., aspirin), and thyroid hormones (e.g., levothyroxine).[10][11]
IGF-1 and Glucose Monitoring
Sermorelin may help increase IGF-1 levels, which may require periodic serum testing as both low and high IGF-1 levels have been linked to cardiovascular risks in certain patient populations.[12]
GH secretion may exacerbate insulin resistance, so patients may require frequent glucose monitoring, especially those with diabetes or prediabetes.[3]
Injection Site Reactions
Subcutaneous administration may cause localized pain or irritation. Proper injection technique—rotating sites and using sterile practices—minimizes discomfort and helps prevent complications.[13]
Critical Illness Considerations
Sermorelin is not recommended for patients with acute critical illnesses (e.g., postoperative complications or respiratory failure), as GH modulation may increase mortality risk in these populations.[14]
Special Populations
Sermorelin’s use in patients with growth hormone deficiency due to intracranial lesions is unestablished. Sermorelin should be avoided in this patient population.[9]
Geriatric Use
Older adults may be more susceptible to certain potential side effects of growth hormone replacement, including fluid retention and arthralgia. Dosage adjustments may be necessary to mitigate these potential side effects.[5]
Testosterone Cream
Cyanocobalamin Tablets
Bi-Est Vaginal Cream
Estriol Vaginal Cream
Progesterone Cream
Estradiol Cream
Modafinil Tablets
Hydroxocobalamin (Vitamin B12) Injection
Arginine HCl Injection
Norditropin Injection