Becaplermin 

Uses For becaplermin 

Becaplermin is used to treat skin ulcers, usually on  the lower leg,  in patients with type 2 diabetes mellitus. It works  by stimulating the wound to heal.  It is important to use other methods for  good skin ulcer care when using becaplermin. 

Becaplermin is available only with your doctor's prescription. 

Before Using becaplermin 

In deciding  to use a medicine, the risks of taking the medicine must be weighed against the good it will do.  This is a decision you and  your doctor will make. For becaplermin, the following  should be considered: 

Allergies: Tell your doctor if you have ever had any unusual or allergic reaction to becaplermin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. 

Pediatric: Appropriate studies have not been performed on  the relationship of age  to the effects of  becaplermin in children and teenagers below 16 years  of age. Safety and efficacy have not been established. 

Geriatric: Appropriate studies performed  to date have not demonstrated geriatric-specific problems that would limit  the usefulness of becaplermin in  the elderly. 

Interactions with Medicines:  lthough certain medicines should not be used together at all, in other cases two different medicines  may be used together even if an interaction might occur. In these cases,  your doctor may want to change  the dose, or other precautions may be necessary. Tell  your healthcare professional if you are taking any other  prescription or nonprescription (over-the-counter OTC) medicine. 

Interactions with Food/Tobacco/Alcohol 

Certain medicines should  not be used at  or around the time  of eating food  or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with  your healthcare professional the use of your medicine with food, alcohol, or tobacco. 

Other Medical Problems 

The presence of other medical problems may affect the use of becaplermin. Make sure you tell your doctor if you have any other medical problems, especially: 

• Cancer, any type—Use with caution. May make this condition worse. 
• Skin cancer or tumors at the site of the ulcer—should not be used in patients with this condition. 
• Wounds that show exposed joints, tendons, ligaments, or bone—Use of becaplermin is not recommended because it is not known if it would work for these conditions. 
• Wounds that are closed manually by  your doctor—Use of becaplermin is not recommended because these wounds require a sterile product. 

Proper Use  of becaplermin 

To make using becaplermin as safe and reliable as possible, you should understand how and when to use becaplermin and what effects may be expected. becaplermin comes with patient instructions. Read and follow these instructions carefully. Ask  your doctor if  you have any questions. 

It is important  to prevent the  tip of the tube from touching  the skin ulcer or any other object. This will keep  the medicine from becoming impure and a possible source of infection. 

There are several important steps that will help you apply your medicine properly:
Wash your hands before preparing your dose. 

• The proper amount to measure depends on the size of the tube you are using and the size of the skin ulcer. You should expect the dose to change each week or every other week, depending on the rate your skin ulcer changes in size. 
• Measure the proper amount carefully onto  a clean surface (e.g., wax paper). Then, transfer the medicine to your skin ulcer by using an applicator aid (e.g., a  cotton swab, tongue depressor). 
• Spread  the medicine on your skin  ulcer as a thin (about  1/16th of an inch), even, continuous film. 
• After wetting  a gauze pad with 0.9% Sodium Chloride Irrigation USP, apply it on top of your medicated skin ulcer. 
• After 12 hours, remove the medicine left on  the skin ulcer with 0.9% Sodium Chloride Irrigation USP  or water. 
• Keep  the ulcer from becoming too dry. When changing the dressing, the existing bandage may need to be wetted  with 0.9% Sodium Chloride Irrigation USP to help remove the bandage and prevent injury to the healing ulcer. 
• Wet  a new gauze pad  with 0.9% Sodium Chloride Irrigation USP. Apply it on top of your skin ulcer that no longer has the medicine on it and wait 12 hours before applying the medicine again. Therefore, the medicine is reapplied every 24 hours, with a change in the wound dressing in between applications. 

Dosing

The dose of becaplermin will  be different for different patients. Follow  your doctor's orders or the directions on the label. The following information includes only the average doses of becaplermin. If your dose is different, do not change it unless your doctor tells you  to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem  for which you are using the medicine. 

• For topical dosage form (gel): 
• For skin ulcers caused by type 2 diabetes mellitus: 
• Adults and children 16 years of age and over—Apply an amount of gel once a day and leave it on for twelve hours. The amount applied will change each week or every other week, depending on the changing size of the skin ulcer. 
• Children  up to 16 years of age—Use and dose  must be determined by your doctor. 

Missed Dose 

If you miss a dose of becaplermin, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. 

Storage

Store  in the refrigerator. Do not freeze. 

Keep  out of the reach of children.

Do not keep outdated medicine or medicine no longer needed. 

Ask your healthcare professional how you should dispose of any medicine you do  not use. 

Becaplermin should not be used  after the expiration date. The  date can be found  at the bottom of the tube.

Precautions while using becaplermin 

Your doctor should check your progress at regular visits to make sure that becaplermin does not cause unwanted effects. As your skin ulcer changes in size, your doctor may change your dose each week or every other week. 

Becaplermin works best when used with other methods for good skin ulcer care, such as not bearing weight on the leg that has the skin ulcer. Your doctor will discuss these methods with you. 

Discuss  with your doctor whether you should continue  the medicine if your skin ulcer is  not reduced in size by 30% in 10 weeks  or your skin ulcer does not improve after 20 weeks. If your skin ulcer does improve,  your doctor may keep  you on the medicine until the ulcer is completely healed. 

It is important to use the proper amount and  not to use more than prescribed. Using too much of becaplermin may increase  your risk of having cancer. Your doctor will decide if  you should continue to use becaplermin based on how well  your ulcer has healed.