1.1. Pediatrics

Mecasermin is approved for use in children 2 years of age and older, but has not been studied in adults. Mecasermin should not be used in children whose bone growth plates are closed (epiphyseal closure), as linear growth is no longer possible in these patients. Additionally, mecasermin safety and efficacy have not been determined in children younger than 2 years of age. The recommended initial mecasermin dosage is 0.04 to 0.08 mg/kg twice daily subcutaneously, which can be titrated up in increments of 0.04 mg/kg, if tolerated, to a maximum dose of 0.12 mg/kg twice daily (total: 0.24 mg/kg/day). Patient profiles containing prescriptions for doses exceeding these recommendations will be reviewed^1-3 .

Mecasermin should be administered with food or a snack as IGF-1 decreases hepatic glucose production and increases peripheral glucose utilization and may induce hypoglycemia. Mecasermin administration should be withheld in patients unable or unwilling to eat a meal prior to mecasermin dosing^1-3.