Usual Adult Dose for Diabetic Neuropathy

Apply calculated amount of gel over the entire ulcer area once a day until complete healing has occurred. To calculate the length of gel to apply, measure the greatest length and greatest width of the ulcer in inches or centimeters and use the appropriate formula based on unit of measure and tube size.

Inches:
15 g tube: length x width x 0.6 = length of gel (in)
2 g tube: length x width x 1.3 = length of gel (in)

Centimeters:
15 g tube: (length x width) divided by 4 = length of gel (cm)
2 g tube: (length x width) divided by 2 = length of gel (cm)

Comments:

• The amount of gel to be applied should be recalculated by the physician or wound caregiver every week or every other week depending on the rate of change in ulcer area.
• If the ulcer does not decrease in size by approximately 30% after 10 weeks or complete healing has not occurred in 20 weeks, continued treatment should be reassessed.

Use: Treatment of lower extremity diabetic neuropathic ulcers that extend into the subcutaneous tissue or beyond and have an adequate blood supply, when used as an adjunct to, and not a substitute for, good ulcer care practices including initial sharp debridement, pressure relief, and infection control.

Usual Pediatric Dose for Diabetic Neuropathy

16 Years or Older:
Apply calculated amount of gel over the entire ulcer area once a day until complete healing has occurred. To calculate the length of gel to apply, measure the greatest length and greatest width of the ulcer in inches or centimeters and use the appropriate formula based on unit of measure and tube size.

Inches:
15 g tube: length x width x 0.6 = length of gel (in)
2 g tube: length x width x 1.3 = length of gel (in)

Centimeters:
15 g tube: (length x width) divided by 4 = length of gel (cm)
2 g tube: (length x width) divided by 2 = length of gel (cm)

Comments:

• The amount of gel to be applied should be recalculated by the physician or wound caregiver every week or every other week depending on the rate of change in ulcer area.
• If the ulcer does not decrease in size by approximately 30% after 10 weeks or complete healing has not occurred in 20 weeks, continued treatment should be reassessed.

Use: Treatment of lower extremity diabetic neuropathic ulcers that extend into the subcutaneous tissue or beyond and have an adequate blood supply, when used as an adjunct to, and not a substitute for, good ulcer care practices including initial sharp debridement, pressure relief, and infection control.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNING:

• INCREASED RATE OF MORTALITY SECONDARY TO MALIGNANCY: An increased rate of mortality secondary to malignancy was observed in patients treated with 3 or more tubes of this drug in a postmarketing retrospective cohort study. This drug should only be used when the benefits can be expected to outweigh the risks. Use with caution in patients with known malignancy.

Safety and efficacy have not been established in patients younger than 16 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available