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Precautions and Warnings With Mecasermin

Mecasermin has been reported to cause low blood sugar levels, enlarged tonsils, and other problems. To help minimize the risk, make sure your child's healthcare provider has his or her complete medical history, as well as a current list of all medications. Other warnings and precautions associated with mecasermin apply to those who have certain allergies and those who have any type of cancer.


What Should I Tell My Child's Healthcare Provider?

Talk with your child's healthcare provider prior to using mecasermin (Increlex®) if your child has:
  • Liver disease, such as hepatitis, cirrhosis, or liver failure
  • Kidney disease, such as kidney failure (renal failure)
  • Cancer of any type
  • Diabetes
  • Enlarged tonsils
  • Scoliosis (a curved spine)
  • Had a head injury
  • Finished growing
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your child's healthcare provider know if your child is:
You should also tell your child's healthcare provider about all other medications your child is taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Mecasermin Precautions and Warnings

Some warnings and precautions to be aware of prior to using this drug include the following:
  • Mecasermin has insulin-like effects on blood sugar, which means it can cause low blood sugar levels (hypoglycemia). In order to reduce the risk for low blood sugar levels, your child should eat a meal or snack within 20 minutes before or after each dose. Your child's healthcare provider will explain to you what to do if your child develops signs of hypoglycemia. Some signs of hypoglycemia may include:
    • Sweating
    • Hunger
    • Shakiness
    • Dizziness
    • Nausea
    • Tiredness or weakness
    • Restlessness
    • Irritability
    • Difficulty concentrating
    • Confusion
    • A fast or irregular heartbeat.
  • Do not give your child a dose if he or she cannot eat for any reason, as doing so could cause dangerously low blood sugar levels. If your child must skip a dose because he or she cannot eat, do not give a double dose later to make up for the missed dose.
  • Because this medicine can cause a drop in blood sugar, your child should not drive or do any other activity that requires mental alertness within two to three hours after receiving a dose.
  • There have been reports of allergic reactions occurring with mecasermin use. This includes local reactions at the injection site, as well as body-wide reactions. Let your child's healthcare provider know if your child has reactions at the site of the injection, such as persistent or severe pain, redness, or bruising, or an increase or loss of fat around the area. Seek immediate medical attention if your child has signs of an allergic reaction to mecasermin, such as:
    • An unexplained rash
    • Hives
    • Itching
    • Unexplained swelling of the face, mouth, or throat
    • Wheezing
    • Difficulty breathing or swallowing.
  • This medication can cause an increase in pressure within the brain (known medically as intracranial hypertension). Let your child's healthcare provider know right away if your child has signs of intracranial hypertension, such as changes in vision or a headache with nausea and vomiting. If your child develops high pressure within the brain, he or she may need to stop using mecasermin, at least until the issue resolves.
  • This medication may enlarge your child's tonsils, which could lead to snoring, problems breathing or swallowing, sleep apnea (a brief period of not breathing while sleeping), or fluid buildup in the middle ear. Your child's healthcare provider will monitor your child's tonsils during treatment.
  • The rapid growth caused by this medication could lead to a problem with the hip joint known as slipped capital femoral epiphysis. This occurs when the ball at the upper end of the thigh bone (the femur) slips off. The condition can lead to deformity and should be treated as soon as possible. Let your child's healthcare provider know right away if your child develops a limp, or has hip or knee pain.
  • If your child has scoliosis, this medicine could make it worse. Your child will need to be checked often.
  • Mecasermin contains benzyl alcohol. High doses of benzyl alcohol have been reported to cause a condition known as "gasping syndrome" when given to very young or premature infants. Gasping syndrome can lead to serious problems, such as:
  • It is unknown if mecasermin passes through breast milk. Therefore, if your child is breastfeeding or plans to start, discuss this with your child's healthcare provider prior to using the drug (see Increlex and Breastfeeding).
  • Mecasermin is a pregnancy Category C medication, which means it may not be safe for use during pregnancy (see Increlex and Pregnancy).
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Mecasermin Drug Information

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