Somavert

Monitor tumor growth, IGF-I levels, and for the development of GH deficiency. Obtain baseline ALT, AST, TBIL, ALP; if normal, monitor liver function monthly for first 6 months, then quarterly for next 6 months, then biannually for the next year; if elevated but ≤3×ULN, monitor monthly for ≥1yr, then biannually for the next year; if >3×ULN, do not treat until cause of liver dysfunction determined. Liver dysfunction during therapy: if ≥3×ULN but <5×ULN, monitor liver function weekly; if ≥5×ULN, or transaminase elevations ≥3×ULN associated with increase in TBIL, discontinue immediately, consider reinitiation if liver function normalizes with frequent monitoring; if liver injury occurs, discontinue therapy. Diabetes (monitor and adjust doses). Monitor closely when re-initiating therapy after systemic hypersensitivity reactions. Elderly. Pregnancy. Nursing mothers.