Recombinant Human Insulin-Like Growth Factor-1: Benefits & Risks

Summary of Key Points

Recombinant human insulin-like growth factor-1 (rhIGF-1) is a medication used to treat various growth-related conditions, including growth hormone deficiency, Turner syndrome, and Prader-Willi syndrome. It supports growth and development in both children and adults with specific medical needs. Administered by injection, this medication should only be used under the supervision of a healthcare provider. Always consult your doctor before starting or adjusting your dose.

Names of Medication

US Brand Name: Increlex

Generic Name: Recombinant human insulin-like growth factor-1 (rhIGF-1)

The generic name refers to the chemical composition of the active ingredient in the medication and is listed in parentheses after the brand name.

Pharmacologic Category

Growth Hormone Agonist

Insulin-Like Growth Factor

Dosing for Recombinant Human Insulin-Like Growth Factor-1 (rhIGF-1)

Recombinant human insulin-like growth factor-1 (rhIGF-1) is prescribed to treat several growth and developmental conditions. The dosage varies depending on the specific condition being treated. Always follow your doctor’s instructions carefully and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.

Growth Hormone Deficiency

Adults: The typical starting dose is 0.04 to 0.08 mg/kg, injected twice daily. The dose may be adjusted based on your response and tolerance to the treatment.

Turner Syndrome

Adults: The recommended dose is 0.045 to 0.05 mg/kg, injected once daily. The duration of treatment depends on the patient’s growth response and overall medical condition.

Prader-Willi Syndrome

Adults: The usual dose is 0.04 to 0.08 mg/kg, injected twice daily. The dose may be adjusted based on individual response to the therapy.

Chronic Kidney Disease

Adults: The recommended dose is 0.045 to 0.05 mg/kg, injected once daily. Treatment duration is determined by the patient’s growth response and kidney function.

Short Stature

Adults: The typical dose is 0.04 to 0.08 mg/kg, injected twice daily. The dose may be adjusted depending on the individual’s growth response.

Idiopathic Short Stature

Adults: The recommended dose is 0.04 to 0.08 mg/kg, injected twice daily. The length of treatment will depend on the patient’s growth response.

Hypoglycemia

Adults: The typical dose is 0.04 to 0.08 mg/kg, injected twice daily. Your doctor will adjust the dose based on your blood sugar levels.

Insulin Resistance

Adults: The usual dose is 0.04 to 0.08 mg/kg, injected twice daily. Your doctor will monitor your response to treatment and adjust the dose as necessary.

Muscle Wasting

Adults: The recommended dose is 0.04 to 0.08 mg/kg, injected twice daily. The dose may be adjusted based on the severity of muscle wasting and your response to treatment.

Osteoporosis

Adults: The typical dose is 0.04 to 0.08 mg/kg, injected twice daily. The duration of treatment may vary depending on bone density and response to therapy.

Dosage Forms and Strengths of IGF-1 Therapy

Injection: 10 mg/mL solution in a 4 mL vial

Administration Instructions for IGF-1 Injections

Recombinant human insulin-like growth factor-1 (rhIGF-1) is administered as a subcutaneous injection, typically in the thigh, upper arm, or abdomen. It is important to rotate injection sites to prevent skin irritation. The medication should be injected at the same time each day, following your healthcare provider’s instructions. If you miss a dose, take it as soon as you remember, but do not double up on doses. Always wash your hands before and after handling the medication.

Adverse Reactions and Side Effects of IGF-1 Therapy

Like all medications, recombinant human insulin-like growth factor-1 (rhIGF-1) can cause side effects. Some are common and mild, while others may be more serious. If you experience any side effects, contact your healthcare provider immediately.

Common IGF-1 Side Effects

1. Hypoglycemia (low blood sugar): Symptoms include dizziness, sweating, and shakiness. Eating a snack or drinking juice can help raise blood sugar levels.
2. Injection site reactions: Redness, swelling, or pain at the injection site is common. Rotating injection sites can help reduce irritation.
3. Headache: Mild to moderate headaches may occur, but they usually resolve on their own.

Less Common IGF-1 Side Effects

1. Swelling (edema): Some patients may experience swelling in the hands, feet, or face.
2. Joint pain: Mild to moderate joint pain may occur, especially in the knees or ankles.

Serious Side Effects of Recombinant IGF-1

1. Severe hypoglycemia: If left untreated, low blood sugar can lead to seizures or unconsciousness. Seek medical attention immediately if you experience confusion, blurred vision, or loss of consciousness.
2. Allergic reactions: Symptoms include rash, itching, swelling, or difficulty breathing. If you experience any of these symptoms, seek emergency medical care right away.

Contraindications for Recombinant IGF-1 Therapy

A contraindication is a specific situation or condition where a medication should not be used because it may be harmful. For Recombinant human insulin-like growth factor-1 (rhIGF-1), several contraindications must be discussed with your healthcare provider before starting treatment.

1. Active or suspected malignancy (cancer): rhIGF-1 can promote cell growth, which may worsen existing cancer or increase the risk of developing new cancers.
2. Closed epiphyses: In children, growth plates (epiphyses) in the bones must be open for rhIGF-1 to be effective. If the growth plates are closed, the medication will not promote further growth.
3. Hypersensitivity to rhIGF-1: If you have had an allergic reaction to rhIGF-1 or any of its components, you should not take this medication as it could cause severe allergic reactions, including anaphylaxis.
4. Intracranial hypertension: rhIGF-1 may increase the risk of elevated pressure in the brain, leading to headaches, nausea, and vision problems.
5. Uncontrolled hypoglycemia: rhIGF-1 can lower blood sugar levels, so it is not recommended for patients who already struggle with managing low blood sugar.

Drug to Drug Interactions with Recombinant Human Insulin-Like Growth Factor-1

Recombinant human insulin-like growth factor-1 (rhIGF-1) may interact with other medications, potentially altering its effectiveness or increasing the likelihood of side effects. It is crucial to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements. Some known interactions include:

1. Insulin or other diabetes medications: rhIGF-1 can lower blood sugar levels. When taken alongside insulin or medications such as metformin (Glucophage) or glipizide (Glucotrol), the risk of hypoglycemia may increase.
2. Corticosteroids: Drugs like prednisone (Deltasone) may reduce the effectiveness of rhIGF-1 by interfering with its growth-promoting properties.
3. Growth hormone: Combining rhIGF-1 with growth hormone treatments, such as somatropin (Genotropin), may heighten the risk of side effects, including joint pain and swelling.

Recombinant Human Insulin-Like Growth Factor-1 in Pregnancy

There is limited information regarding the safety of rhIGF-1 during pregnancy. While animal studies suggest potential risks, there is insufficient data to determine its safety in pregnant women. If you are pregnant or planning to become pregnant, it is important to discuss the potential risks and benefits of IGF-1 therapy with your healthcare provider. In most cases, rhIGF-1 is not recommended during pregnancy unless the potential benefits clearly outweigh the risks.

Recombinant Human Insulin-Like Growth Factor-1 While Breastfeeding

It is unclear whether rhIGF-1 passes into breast milk. Due to the potential risks to a breastfeeding infant, it is generally advised to avoid rhIGF-1 while breastfeeding. If you are considering IGF-1 therapy and are currently breastfeeding, consult your healthcare provider to carefully weigh the risks and benefits. Alternative treatments may be recommended during this time.

Estimated Cost of Recombinant Human Insulin-Like Growth Factor-1

The cost of a 30-day supply of rhIGF-1 without insurance can be substantial. With a GoodRx coupon, prices typically range from $5,000 to $6,000, depending on the pharmacy and dosage. It is advisable to check with your insurance provider to determine if this medication is covered, as insurance may significantly reduce your out-of-pocket expenses.

Possible Alternatives to IGF-1 Therapy

Depending on the condition being treated, alternative therapies or lifestyle modifications may help manage symptoms. Always consult your healthcare provider before making any changes to your treatment plan. If you need guidance, you can schedule a telemedicine appointment with one of our providers to explore your options.

1. Growth hormone deficiency: Alternatives include growth hormone therapy (somatropin) or optimizing nutrition and exercise to support growth.
2. Turner syndrome: Growth hormone therapy and estrogen replacement therapy may help manage symptoms. Regular monitoring of heart and kidney health is also essential.
3. Prader-Willi syndrome: Growth hormone therapy, combined with a controlled diet and physical activity, can help manage growth and reduce the risk of obesity.
4. Chronic kidney disease: Managing blood pressure, controlling blood sugar, and making dietary changes are key. Growth hormone therapy may be used for children with growth issues related to kidney disease.
5. Short stature: Growth hormone therapy or addressing underlying causes, such as nutritional deficiencies, may help. In some cases, no treatment is necessary, and regular monitoring is sufficient.
6. Idiopathic short stature: Growth hormone therapy may be considered, but some children may not require treatment if their short stature does not impact their overall health.
7. Hypoglycemia: Dietary changes, such as eating frequent small meals, and medications like diazoxide (Proglycem) may help manage low blood sugar levels.
8. Insulin resistance: Lifestyle changes, including weight loss, increased physical activity, and medications like metformin, can help improve insulin sensitivity.
9. Muscle wasting: Resistance training, adequate protein intake, and medications like anabolic steroids or selective androgen receptor modulators (SARMs) may help combat muscle loss.
10. Osteoporosis: Calcium and vitamin D supplements, weight-bearing exercises, and medications like bisphosphonates (alendronate) can help strengthen bones and reduce the risk of fractures.

Recent Updates on Recombinant Human Insulin-Like Growth Factor-1 Research

Recent research on rhIGF-1 has expanded its potential applications beyond growth disorders. Studies are exploring its role in managing muscle wasting in patients with chronic illnesses, such as cancer and HIV/AIDS, as well as its potential benefits for individuals with insulin resistance and type 2 diabetes. Early findings suggest that rhIGF-1 may improve insulin sensitivity and help lower blood sugar levels, though further research is needed to confirm these results.

Additionally, ongoing clinical trials are investigating the long-term safety of rhIGF-1, particularly its impact on cancer risk and cardiovascular health. As more data becomes available, healthcare providers will gain a clearer understanding of the risks and benefits of using rhIGF-1 for various conditions.

If you are interested in learning more about the latest research or have questions about whether rhIGF-1 is right for you, consider scheduling a telemedicine appointment with one of our providers. We can help guide you through the most recent findings and tailor a treatment plan that meets your specific needs.

James Kingsley

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