Becaplermin is a recombinant human platelet-derived growth factor (rhPDGF-BB) formulated as a topical gel. It is a biological response modifier that promotes the chemotactic recruitment and proliferation of cells involved in wound repair, such as fibroblasts and smooth muscle cells, and increases the formation of granulation tissue. It is specifically indicated for the treatment of lower extremity diabetic neuropathic ulcers that extend into the subcutaneous tissue or beyond and have an adequate blood supply.
Adult: Apply a calculated amount of gel once daily. The amount is calculated based on ulcer size: Length (cm) x Width (cm) x 0.6 = grams of gel. A 15g tube contains approximately 2.2 inches (5.5 cm) of gel when squeezed from the tube as a 1/16-inch diameter bead.
Note: 1) Calculate the dose (in grams) daily. 2) Squeeze the calculated length of gel onto a clean, non-absorbent surface (wax paper). 3) Using a clean applicator (tongue depressor, cotton swab), spread a continuous layer (about 1/16 inch thick) over the ulcer surface. 4) Cover with a saline-moistened gauze dressing. 5) After 12 hours, gently rinse the ulcer with saline or water to remove residual gel and re-cover with a moist saline dressing (without gel) for the remainder of the day. Sharp debridement should be repeated as needed.
Becaplermin is a recombinant version of the BB isoform of human platelet-derived growth factor (PDGF). PDGF is a key endogenous regulator in the wound healing cascade. When applied topically, it binds to specific cell surface receptors (PDGFR-α and PDGFR-β) on target cells such as fibroblasts, smooth muscle cells, and glial cells present in the wound bed.
Pregnancy: Category C: Animal reproduction studies have not been conducted. It is not known whether becaplermin can cause fetal harm. Use only if the potential benefit justifies the potential risk to the fetus. Systemic exposure is negligible.
Driving: No effect. Purely topical action.
| Topical Antiseptics (e.g., Povidone-Iodine, Hydrogen Peroxide, Dakin's Solution) | May inactivate the protein (becaplermin). Do not apply concurrently. Rinse ulcer thoroughly with saline/water before becaplermin application. | Major |
| Other Topical Medications (e.g., antibiotics, corticosteroids, enzymatic debriding agents) | Potential for physical/chemical interaction or altered absorption. Apply at different times after consulting a physician. | Moderate |
| Systemic Cancer Chemotherapeutic Agents | Theoretical antagonism of wound healing. Clinical significance is unknown. | Moderate |
Same composition (Becaplermin (100mcg)), different brands: