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Contraindications 

• Hypersensitivity to mecasermin (rhIGF-1), any of the inactive ingredients in INCRELEX^®, or who have experienced a severe hypersensitivity to INCRELEX^®. Allergic reactions have been reported, including anaphylaxis requiring hospitalization.
• Intravenous Administration.
• Closed Epiphyses.
• Malignant Neoplasia in pediatric patients with malignant neoplasia or a history of malignancy.

Warnings and Precautions

• Hypoglycemia: INCRELEX^® should be administered 20 minutes before or after a meal or snack and should not be administered when the meal or snack is omitted. Glucose monitoring and INCRELEX^® dose titration are recommended until a well-tolerated dose is established and as medically indicated.
• Intracranial Hypertension: Funduscopic examination is recommended at the initiation of and periodically during the course of therapy.
• Lymphoid Tissue Hypertrophy: Patients should have periodic examinations to rule out potential complications.
• Slipped Capital Femoral Epiphysis: Carefully evaluate any pediatric patient with the onset of a limp or hip/knee pain during INCRELEX^® therapy.
• Progression of Scoliosis: Patients with a history of scoliosis, treated with INCRELEX^®, should be monitored.
• Malignant Neoplasia: There have been postmarketing reports of malignant neoplasia in pediatric patients who received treatment with INCRELEX^®. The tumors were observed more frequently in patients who received INCRELEX^® at higher than recommended doses or at doses that produced serum IGF-1 levels above the normal reference ranges for age and sex. Monitor all patients receiving INCRELEX^® carefully for development of neoplasms. If malignant neoplasia develops, discontinue INCRELEX^® treatment.
• Risk of Serious Adverse Reactions in Infants due to Benzyl Alcohol Preserved Solution: Serious and fatal adverse reactions including “gasping syndrome” can occur in neonates and infants treated with benzyl alcohol-preserved drugs. Use of INCRELEX^® in infants is not recommended.

Adverse Reactions

Common adverse reactions include hypoglycemia, local and systemic hypersensitivity, and tonsillar hypertrophy.

Indication

INCRELEX^® (mecasermin) is indicated for the treatment of growth failure in pediatric patients aged 2 years and older with severe primary IGF-1 deficiency^* (IGFD), or with hormone (GH) gene deletion who have developed neutralizing antibodies to GH.¹

Limitations of use: INCRELEX^® is not a substitute to GH for approved GH indications. INCRELEX^® is not indicated for use in patients with secondary forms of IGFD, such as GH deficiency, malnutrition, hypothyroidism, or chronic treatment with pharmacologic doses of anti-inflammatory steroids.¹

^*Severe primary IGF-1 deficiency (IGFD) is defined by height standard deviation score ≤ -3.0 and basal IGF-1 standard deviation score ≤ -3.0 and normal or elevated GH.