When This Medicine Should Not Be Used:
This medicine is not right for everyone. Your child should not receive it if he had an allergic reaction to mecasermin.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Use a new needle and syringe each time you inject your medicine.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Do not use the medicine if it looks cloudy or has particles in it.
• Give this medicine within 20 minutes before or after your child eats a meal or snack. Never let your child skip a meal once he has received this medicine.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• If you store this medicine at home, keep it in the refrigerator. Do not freeze. Protect from direct heat and light. Use a vial within 30 days after opening.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how mecasermin works. Tell your doctor about all other medicines your child is using, including insulin or other diabetes medicines.

Warnings While Using This Medicine:

• Tell your doctor knows if your child is pregnant or breastfeeding, or if he or she has kidney disease, liver disease, cancer, diabetes, or a history of scoliosis (curved spine).
• This medicine may cause the following problems:
  
  • Low blood sugar
  • Intracranial hypertension (increased pressure inside the head)
  • Enlarged tonsils
  • Increased risk of dislocated hip bone
• This medicine may make your child feel dizzy or faint. Your child should not drive or do anything else that may be dangerous within 2 to 3 hours after receiving the medicine, especially at the start of treatment.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Dizziness, drowsiness, trouble concentrating
• Ear pain or discharge
• Limping, hip or knee pain
• Severe headache, vision problems, nausea, vomiting
• Shaking, trembling, sweating, fast or pounding heartbeat, lightheadedness, hunger, confusion
• Swollen tonsils, snoring, trouble breathing or swallowing

If you notice these less serious side effects, talk with your doctor:

• Pain, redness, bruising, or skin changes where the shot was given

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088