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Interactions between Somatrogon and Vorapaxar

1 drug interaction and 27 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

vorapaxar somatrogon

Applies to: vorapaxar and somatrogon
Monitor

Coadministration with human growth hormone (hGH) receptor agonists may alter the clearance and plasma concentrations of medicinal products that are metabolized by CYP450 isoenzymes. The mechanism of this interaction may be mediated via the effects of hGH receptor agonists on expression of different CYP450 isoenzymes. The labeling of some hGH receptor agonists specify that this interaction may be the most significant for substrates of CYP450 3A4 and/or 1A2 and indicate that their clearance may be increased. However, clinical data are limited, and clinical significance is unknown. In a study of 11 growth hormone (GH)-deficient adults randomized to GH or placebo for 6 months followed by 3 months of GH for all subjects, antipyrine clearance, a non-specific marker of hepatic CYP450 activity, increased in all subjects who received GH treatment compared to placebo. In vitro studies have indicated that GH enhanced CYP450 3A4 gene expression; however, other studies have suggested that when administered in a pulsatile fashion, CYP450 3A4 activity is reduced. A study in healthy elderly men did not reveal any effects on CYP450 3A4 or 2D6 but did demonstrate induction of 1A2 and inhibition of 2C19. Given that studies have varied in the type of growth hormone used, dosing regimens, ages and sexes of the patients and/or cell lines utilized, it is difficult to predict how coadministration may affect the CYP450 substrate.

Management

Careful monitoring is advised when drugs that are metabolized by CYP450 isoenzymes are used in combination with hGH receptor agonists. As this interaction's clinical significance is unknown, the label of the specific hGH receptor agonist and CYP450 substrate(s) being coadministered should be consulted for more specific guidance.

References (20)
  1. (2003) "Product Information. Humatrope (somatropin)." Lilly, Eli and Company
  2. (2004) "Product Information. Zorbtive (somatropin)." Serono Laboratories Inc
  3. (2025) "Product Information. Skytrofa (lonapegsomatropin)." Ascendis Pharma, Inc., DailyMed
  4. (2025) "Product Information. Norditropin (somatropin)." Novo Nordisk Pharmaceuticals Inc
  5. (2024) "Product Information. Norditropin FlexPro (somatropin)." Novo Nordisk Ltd
  6. (2020) "Product Information. Genotropin Miniquick (somatropin)." Pfizer Canada ULC
  7. (2025) "Product Information. Ngenla (somatrogon)." Pfizer U.S. Pharmaceuticals Group
  8. (2025) "Product Information. Ngenla (somatrogon)." Pfizer Canada ULC
  9. (2026) "Product Information. Ngenla (somatrogon)." Pfizer Australia Pty Ltd
  10. (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Pty Ltd
  11. (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Inc
  12. (2023) "Product Information. Sogroya (somapacitan)." Novo Nordisk Canada Inc
  13. (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Ltd, 2
  14. (2026) "Product Information. Ngenla (somatrogon)." Pfizer Ltd
  15. Cheung NW, Liddle C, Coverdale S, Lou JC, boyages sc (1996) "Growth hormone treatment increases cytochrome P450-mediated antipyrine clearance in man" The Journal of Clinical Endocrinology & Metabolism, 81, p. 1996-2001
  16. Dhir RN, Dworakowski W, Thangavel C, Shapiro BH (2006) "Sexually dimorphic regulation of hepatic isoforms of human cytochrome P450 by growth hormone" The Journal of Pharmacology and Experimental Therapeutics, 316, p. 87-94
  17. Jurgens G, Lange KHW, Reuther LO, et al (2002) "Effect of growth hormone on hepatic cytochrome P450 activity in healthy elderly men" Clin Pharmacol and Therapeutic, 71, p. 162-8
  18. jaffe ca, turgeon dk, Demott-Friberg R, Watkins PB (2002) "Growth hormone secretion pattern is an independent regulator of growth hormone actions in humans" American Journal of Physiology-Endocrinology and Metabolism, 283, E1008-E1015
  19. (2025) "Product Information. Saizen (somatropin)." Merck Serono Australia Pty Ltd, A015-0925
  20. (2025) "Product Information. Skytrofa (lonapegsomatropin)." Specialised Therapeutics Pharma Pty Ltd

Food/lifestyle interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

27 potential interactions Applies to: 22 conditions, including Weight Loss, Breast Cancer, Sleep Apnea, Prostate Cancer, and Scoliosis.

Acute Abdomen

Major:

somatrogon

Somatrogon has a major potential interaction with Acute Abdomen.

Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.

Bladder Cancer

Major:

somatrogon

Somatrogon has a major potential interaction with Bladder Cancer.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Bleeding Associated with Coagulation Defect

Major:

vorapaxar

Vorapaxar has a major potential interaction with Bleeding Associated with Coagulation Defect.

Vorapaxar increases the risk of bleeding and it is contraindicated in patients with active pathological bleeding such as intracranial hemorrhage or peptic ulcer. In other patients, consider the underlying risk of bleeding before initiating therapy. General risk factors include older age, low body weight, reduced renal or hepatic function, history of bleeding disorders, and use of certain concomitant medications. The use of warfarin and other anticoagulants should be avoided. Bleeding should be suspected in any patient who is hypotensive and has recently undergone coronary angiography, percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG), or any other surgical procedure.

Brain Tumor

Major:

somatrogon

Somatrogon has a major potential interaction with Brain Tumor.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Breast Cancer

Major:

somatrogon

Somatrogon has a major potential interaction with Breast Cancer.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Cerebral Thrombosis/Embolism

Major:

vorapaxar

Vorapaxar has a major potential interaction with Cerebral Thrombosis/Embolism.

Vorapaxar is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), or intracranial bleeding. The risk of intracranial bleeding is higher in these patients.

Diabetes Mellitus

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Diabetes Mellitus.

Somatrogon may increase the risk of diabetes mellitus (DM) in patients with Turner syndrome. Monitor blood glucose levels periodically to assess for new onset diabetes in these patients. In patients with Turner syndrome and preexisting DM, monitor blood glucose more closely as adjustment of antidiabetic agents may be required when somatrogon is initiated.

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Diabetes Mellitus.

Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.

Diabetic Retinopathy

Major:

somatrogon

Somatrogon has a major potential interaction with Diabetic Retinopathy.

Somatropin, somatrogon , and lonapegsomatropin are contraindicated in patients with active proliferative or severe non-proliferative diabetic retinopathy since treatment may worsen condition.

Hemorrhagic Stroke

Major:

vorapaxar

Vorapaxar has a major potential interaction with Hemorrhagic Stroke.

Vorapaxar is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), or intracranial bleeding. The risk of intracranial bleeding is higher in these patients.

Major:

vorapaxar

Vorapaxar has a major potential interaction with Hemorrhagic Stroke.

Vorapaxar increases the risk of bleeding and it is contraindicated in patients with active pathological bleeding such as intracranial hemorrhage or peptic ulcer. In other patients, consider the underlying risk of bleeding before initiating therapy. General risk factors include older age, low body weight, reduced renal or hepatic function, history of bleeding disorders, and use of certain concomitant medications. The use of warfarin and other anticoagulants should be avoided. Bleeding should be suspected in any patient who is hypotensive and has recently undergone coronary angiography, percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG), or any other surgical procedure.

History - Cerebrovascular Disease

Major:

vorapaxar

Vorapaxar has a major potential interaction with History - Cerebrovascular Disease.

Vorapaxar is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), or intracranial bleeding. The risk of intracranial bleeding is higher in these patients.

Liver Disease

Major:

vorapaxar

Vorapaxar has a major potential interaction with Liver Disease.

No dose adjustment is required in patients with renal dysfunction or mild to moderate hepatic impairment. Vorapaxar is not recommended in patients with severe hepatic impairment due to bleeding risk.

Lung Cancer

Major:

somatrogon

Somatrogon has a major potential interaction with Lung Cancer.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Papilledema Associated with Increased Intracranial Pressure

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Papilledema Associated with Increased Intracranial Pressure.

Intracranial hypertension with papilledema, visual changes, nausea and/or vomiting has been reported in a small number of patients treated with somatropin, somatrogon , and lonapegsomatropin . Fundoscopic examination should be performed before treatment initiation to exclude preexisting papilledema, and should be continued periodically during treatment. If papilledema is observed during treatment, therapy should be stopped. Treatment could be restarted at a lower dose once intracranial hypertension has been resolved. Patients with Turner Syndrome might be at increased risk of developing intracranial hypertension.

Peptic Ulcer

Major:

vorapaxar

Vorapaxar has a major potential interaction with Peptic Ulcer.

Vorapaxar increases the risk of bleeding and it is contraindicated in patients with active pathological bleeding such as intracranial hemorrhage or peptic ulcer. In other patients, consider the underlying risk of bleeding before initiating therapy. General risk factors include older age, low body weight, reduced renal or hepatic function, history of bleeding disorders, and use of certain concomitant medications. The use of warfarin and other anticoagulants should be avoided. Bleeding should be suspected in any patient who is hypotensive and has recently undergone coronary angiography, percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG), or any other surgical procedure.

Prostate Cancer

Major:

somatrogon

Somatrogon has a major potential interaction with Prostate Cancer.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Pulmonary Impairment

Major:

somatrogon

Somatrogon has a major potential interaction with Pulmonary Impairment.

Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.

Major:

somatrogon

Somatrogon has a major potential interaction with Pulmonary Impairment.

Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.

Scoliosis

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Scoliosis.

Progression of scoliosis can occur in patients who experience rapid growth. Since somatropin and somatrogon increase growth rate, children with a history of scoliosis should be monitored for progression of this condition. Physicians should be alert for this skeletal abnormality which can be commonly seen in patients with Turner and Prader-Willi syndromes, and can manifest during somatropin and somatrogon treatment.

Sepsis

Major:

somatrogon

Somatrogon has a major potential interaction with Sepsis.

Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.

Skin Cancer

Major:

somatrogon

Somatrogon has a major potential interaction with Skin Cancer.

Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.

Sleep Apnea

Major:

somatrogon

Somatrogon has a major potential interaction with Sleep Apnea.

Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.

Turner Syndrome

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Turner Syndrome.

Somatrogon may increase the risk of diabetes mellitus (DM) in patients with Turner syndrome. Monitor blood glucose levels periodically to assess for new onset diabetes in these patients. In patients with Turner syndrome and preexisting DM, monitor blood glucose more closely as adjustment of antidiabetic agents may be required when somatrogon is initiated.

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Turner Syndrome.

Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.

Weight Loss

Major:

somatrogon

Somatrogon has a major potential interaction with Weight Loss.

Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.

Moderate:

somatrogon

Somatrogon has a moderate potential interaction with Weight Loss.

Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.

More resources

somatrogon

A total of 654 drugs are known to interact with somatrogon.

vorapaxar

A total of 228 drugs are known to interact with vorapaxar.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.