Becaplermin topical (for the skin) is used to treat diabetic foot ulcers in people with normal blood flow in the legs and feet.

becaplermin topical is not for use in treating pressure ulcers (bed sores) or ulcers caused by poor circulation.

Becaplermin topical may also be used for purposes not listed in this medication guide.

You should not use becaplermin topical if you have cancer affecting the skin where you will apply becaplermin topical.

Some people using becaplermin have developed cancer. However, it is not known whether this medicine actually causes cancer.

Becaplermin comes as a gel to apply to the skin. It is usually applied once a day to the ulcer. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use becaplermin gel exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Using more gel than your doctor prescribed will not help your ulcer heal faster.

Your doctor will show you how to measure becaplermin gel and will tell you how much gel to apply. The amount of gel you will need depends on the size of your ulcer. Your doctor will examine your ulcer every 1 to 2 weeks, and may tell you to use less gel as your ulcer heals and grows smaller.

Becaplermin gel is for use on the skin only. Do not swallow the medication. Do not apply the medication to any part of your body other than the ulcer that is being treated.

To apply becaplermin gel, follow these steps:

1. Wash your hands thoroughly.
2. Gently rinse the wound with water. Wash your hands again.
3. Squeeze the length of gel your doctor has told you to use onto a clean, nonabsorbent surface such as wax paper. Do not touch the tip of the tube to the wax paper, the ulcer, or any other surface. Recap the tube tightly after use.
4. Use a clean cotton swab, tongue depressor, or other applicator to spread the gel over the ulcer surface in an even layer about 1/16th of an inch (0.2 centimeters) thick (about as thick as a penny).
5. Moisten a piece of gauze dressing with saline and place it on the wound. The gauze should cover only the wound, not the skin around it.
6. Place a small, dry pad dressing over the wound. Wrap a soft, dry gauze bandage over the pad and hold it in place with adhesive tape. Be careful not to attach the adhesive tape to your skin.
7. After about 12 hours, remove the bandage and gauze dressing and rinse the ulcer gently with saline or water to remove whatever gel is left.
8. Bandage the ulcer following the instructions in steps 5 and 6. Do not reuse the gauze, dressing, or bandage that you removed before washing the ulcer. Use fresh supplies.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Do not take by mouth. Topical medicine is for use only on the skin.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Wash your hands before applying becaplermin topical.

Use a cotton swab, tongue depressor, or other disposable applicator to apply becaplermin topical to your skin.

To keep the tip of the medicine tube from getting contaminated, do not allow the tip to touch any surface, including your fingers or the ulcer you are treating.

It may take several weeks before your symptoms improve. Use this medicine daily and call your doctor if your foot ulcer is not at least one-third smaller in size after 10 weeks, or if it is not completely healed after 20 weeks.

Becaplermin is only part of a complete ulcer care program that includes not putting weight on your leg and foot that is affected by an ulcer. Follow your doctor's instructions very closely.

Your doctor will need to check your foot ulcer on a regular basis.

Store the medicine in a refrigerator. Do not freeze. Keep the tube tightly capped when not in use. Do not use becaplermin topical past the expiration date.

You should not use becaplermin if you are allergic to it, or if you have cancer affecting the skin where you will apply this medicine.

Tell your doctor if you have ever had:

• cancer; or

• blood circulation problems in your lower legs.

Some people using becaplermin have developed cancer. However, it is not known whether becaplermin actually causes cancer. Ask your doctor about this risk.

Tell your doctor if you are pregnant or breastfeeding.

Becaplermin topical is not approved for use by anyone younger than 16 years old.

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

An overdose of becaplermin topical is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.

Keep this medication in the container it came in tightly closed, and out of reach of children. Keep it in the refrigerator at all times but do not freeze it. Do not use the gel after the expiration date marked at the bottom of the tube.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Unless your doctor tells you otherwise, continue your normal diet.

Avoid putting weight on the foot affected with a diabetic ulcer.

Avoid using other medications on the areas you treat with becaplermin unless your doctor tells you to.

Avoid getting becaplermin topical in your eyes, mouth, or vagina.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

This medicine may cause serious side effects. Stop using this medicine and call your doctor at once if you have:

• an increase in the size of the ulcer, or worsening symptoms;

• severe itching;

• skin redness; or

• blistering or peeling skin.

Common side effects of becaplermin topical may include:

• red rash; or

• burning where the medicine was applied.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep all appointments with your doctor.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.