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Somatropin carries well-documented interactions: it opposes insulin action (requiring insulin dose increases of 20-40% in some diabetic patients), alters cortisol metabolism by inhibiting 11-beta-hydroxysteroid dehydrogenase type 1 (potentially unmasking adrenal insufficiency in patients on glucocorticoids), and increases the conversion of T4 to T3 (necessitating levothyroxine dose adjustments in hypothyroid patients) 12
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