[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Growth hormone](https://durgical.com/en/pharmacology/classes/growth-hormone/) › Mecasermin

# Mecasermin

## Growth hormone?

Growth hormone

Recombinant human IGF-1, injected under the skin. It treats short children whose bodies cannot make IGF-1 even with normal growth hormone.

Updated Nov 1, 2026

Also called: Recombinant human IGF-1 (rhIGF-1)

## Quick facts

**Group**
[Growth hormone](https://durgical.com/en/pharmacology/classes/growth-hormone/)

**Target**
Insulin-like growth factor 1 receptor (IGF1R)

**Used for**
Growth failure

**Key effects**
Hypoglycaemia · Snoring and enlarged tonsils

**Monitor**
Blood glucose · Growth velocity and height

**ATC**
H01AC03

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Insulin-like growth factor 1 receptor (IGF1R)**Mecasermin

ⓘ The figure shows human IGF-1 bound to the human IGF-1 receptor (cryo-EM). Mecasermin is recombinant human IGF-1.

**Target in 3D:** Insulin-like growth factor 1 receptor (IGF1R). PDB structure 7YRR (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7YRR) · Drag to rotate · pinch to zoom

Mecasermin is recombinant human insulin-like growth factor 1 (IGF-1), the hormone made mainly by the liver in response to growth hormone. It binds the IGF-1 receptor, a tyrosine kinase, at growth plates and other tissues and drives linear growth. It replaces IGF-1 when the problem is resistance to growth hormone, so giving growth hormone would not help. At high levels it also activates insulin receptors and lowers glucose.

- Mecasermin replaces missing IGF-1
- It activates the IGF-1 receptor tyrosine kinase
- Growth plate chondrocytes proliferate and bones lengthen
- Insulin-like action can lower blood glucose

## Indications

- Growth failure in children aged 2 years and older with severe primary IGF-1 deficiency (growth hormone resistance) who do not respond to growth hormone

## Adverse effects

### Common

- Hypoglycaemia
- Injection-site reactions and fatty lumps (lipohypertrophy)
- Snoring and enlarged tonsils and adenoids
- Headache, ear pain and vomiting
- Joint or limb pain

### Serious (rare, important)

- Severe hypoglycaemia with loss of consciousness or seizures
- Raised intracranial pressure (headache with vision changes, nausea or vomiting)
- Hip or knee pain with limp, which needs prompt assessment
- Allergic reactions

## Contraindications

- Active or past cancer
- Closed growth plates (epiphyses)
- Hypersensitivity to mecasermin

## Key interactions

**Insulin and other glucose-lowering drugs**
Additive hypoglycaemia

**Growth hormone (somatropin)**
Not a substitute: mecasermin is used when the body cannot respond to growth hormone

## What is monitored

- Blood glucose, especially when starting
- Growth velocity and height
- Tonsil size, snoring and sleep apnoea
- Fundoscopy if headache or vision changes
- Hip and knee symptoms and spine (scoliosis)

## Administration and safety

- Subcutaneous injection within 20 minutes before or after a meal or carbohydrate snack
- Injection sites are rotated to avoid lipohypertrophy

## Pregnancy and breastfeeding

It is a paediatric treatment; information in pregnancy is limited.

## Nursing care

- Teach caregivers the signs and treatment of hypoglycaemia
- Make sure a meal or snack goes with every injection
- Ask about snoring, ear pain or sleep problems
- Report headache with vomiting or vision changes, and any limp

## Pharmacokinetics

**Absorption**
Given by subcutaneous injection, usually twice a day

## Memory aid

MECAsermin = «Meal, Every Carb, Always» with each IGF-1 shot, to prevent hypoglycaemia.

## Test yourself

Think of the answer, then tap the question to see it.

## Why does a child with primary IGF-1 deficiency need mecasermin rather than growth hormone?

The defect is resistance to growth hormone, so GH cannot raise IGF-1; mecasermin replaces IGF-1 directly.

## What is the most important adverse effect of mecasermin, and how is it prevented?

Hypoglycaemia; each injection is given within 20 minutes of a meal or carbohydrate snack.

## Name two contraindications to mecasermin?

Active or past cancer, and closed growth plates.

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[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 2

- [Somatropin](https://durgical.com/en/pharmacology/somatropin/)
- [Pegvisomant](https://durgical.com/en/pharmacology/pegvisomant/)

[← Back to the class: Growth hormone](https://durgical.com/en/pharmacology/classes/growth-hormone/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Mecasermin Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a622026.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=H01AC03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/mecasermin/