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mecasermin

Recombinant human insulin-like growth factor 1 (IGF-1) · Treatment of growth disorders

Recombinant human insulin-like growth factor 1 (IGF-1)Treatment of growth disorders
CDSCO approved
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Mecasermin is recombinant human IGF-1. It interacts with receptors on the cell surface that mediate its biological activities, thereby mediating the anabolic and growth-promoting effects typically induced by GH.

Indications

Impaired growth secondary to mutations in the GHR or postreceptor signaling pathwayPatients who develop antibodies against GH that interfere with its actionPatients with IGF-1 gene defects that lead to primary IGF-1 deficiency

Dosing

Pediatric
Typically, the starting dose is 40 to 80 μg/kg twice daily by subcutaneous injection, with a maximum of 120 μg/kg per dose twice daily.

Pharmacokinetics

Half-life
about 6 h (when bound to IGFBP-3 and the acid labile subunit)
Protein binding
Bound by six proteins, including IGFBP-3 and the acid labile subunit, forming a ternary complex that accounts for more than 80% of circulating IGF-1.
Metabolism
Metabolized by both the liver and kidney.
Excretion
Metabolized by both the liver and kidney.

Contraindications

  • Growth promotion in patients with closed epiphyses
  • Active or suspected neoplasia (should be stopped if evidence of neoplasia develops)

Side effects

Common
Hypoglycemia (to diminish frequency, administer shortly before or after a meal or snack)LipohypertrophyLymphoid tissue hypertrophy (including enlarged tonsils, may require surgical intervention)

Related guidelines

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Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team