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What should I discuss with my healthcare provider before using becaplermin topical (Regranex)?

You should not use this medication if you are allergic to becaplermin or parabens, or if you have skin cancer affecting your feet. Do not apply becaplermin over any wound or surgical incision that has been closed with stitches, staples, or surgical tape.

FDA pregnancy category C. It is not known whether becaplermin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether becaplermin topical passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not use this medication on a child younger than 16 years old.

Some people who used 3 or more courses of treatment with becaplermin topical have developed cancer. However, it is not known whether this medication actually causes cancer. Talk with your doctor about your own specific cancer risk.

How should I use becaplermin topical (Regranex)?

Use exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Using more of this medication will not make it work faster and may cause unwanted side effects.

A becaplermin dose is measured by the length of a ribbon of gel squeezed from the medicine tube. To calculate the proper dose, measure the length and width of your ulcer and use one of the following formulas:

• When using a 15-gram tube of becaplermin gel: multiply length x width x 0.6. For example, 2 inches x 1 inch x 0.6 = 1.25 inches of gel.
• When using a 2-gram tube of becaplermin gel: multiply length x width x 1.3. For example, 2 inches x 1 inch x 1.3 = 2.75 inches of gel.
• To measure the dose in centimeters: Multiply length x width and divide by 4 if using a 15-gram tube, or divide by 2 if using a 2-gram tube. For example, 4 centimeters x 2 centimeters / 4 = 2 centimeters of gel from the 15-gram tube; or 4 centimeters x 2 centimeters / 2 = 4 centimeters of gel from the 2-gram tube.
• Ask your doctor, pharmacist, or wound care counselor if you have any questions about how to measure your becaplermin dose.

Make sure you are aware of which tube size you are using when calculating your becaplermin topical dose. Always check your refills to make sure you have received the correct tube size prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

You will need to recalculate your dose about every week or two as the size of your ulcer changes. Follow your doctor's instructions.

Wash your hands before and after using this medication.

To apply becaplermin topical gel:

• Squeeze a ribbon of gel (in the correct length for your ulcer) onto a clean, firm surface that will not absorb the gel such as wax paper.
• To keep the tip of the medicine tube from getting contaminated, do not allow the tip to touch any surface, including your fingers, the firm surface, or the ulcer you are treating.
• Use a cotton swab, tongue depressor, or other disposable applicator to lift the gel from the firm surface
• Spread the gel evenly in a thin layer (about 1/16 of an inch thick) over the ulcerated skin area.
• Cover the treated skin area with a cotton gauze bandage that has been moistened with saline. Leave this gauze dressing on for the next 12 hours.
• After 12 hours have passed, remove the gauze and rinse the ulcer with saline or water to remove the gel. Moisten a new gauze bandage with saline and cover the ulcer without applying any becaplermin gel.

Do not apply becaplermin gel more than once per day and never use more than your prescribed dose.

Use this medication for the full prescribed length of time. Call your doctor if your symptoms do not improve, or if they get worse while using becaplermin topical.

Becaplermin topical is only part of a complete ulcer care treatment program that may also include routine foot exams and avoiding weight on the affected foot. Follow your doctor's instructions very closely.

Store in the refrigerator, do not freeze. Keep the medicine tube tightly capped when not in use. Do not use becaplermin gel past the expiration date on the tube.

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