Short answer: The Increlex label starts at 0.04 to 0.08 mg/kg of body weight twice daily by injection under the skin. If that is well tolerated for at least a week, each dose may go up by 0.04 mg/kg, to a maximum of 0.12 mg/kg twice daily. Each dose is given within 20 minutes before or after a meal or snack, and withheld if the child cannot eat.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Increlex is approved for: Increlex is man-made IGF-1 approved for growth failure in children 2 years and older with severe primary IGF-1 deficiency (height SDS and IGF-1 SDS of -3.0 or lower with normal or high growth hormone), or with growth hormone gene deletion who have developed neutralizing antibodies to growth hormone. It is not a substitute for growth hormone and not for secondary IGF-1 deficiency (section 1).
Source
INCRELEX (mecasermin) injection, for subcutaneous use, prescribing information and Patient Information. Eton Pharmaceuticals. DailyMed, version published May 20, 2026. DailyMed setid d5b2b0e1-c523-468d-9a0b-4ae4e4a8dbce
Increlex is injected under the skin (subcutaneously) only, never into a vein. The site is rotated with each injection among the upper arm, thigh, buttock and abdomen to help prevent fat buildup (section 2.2).
Each dose is given shortly before or after (within 20 minutes of) a meal or snack. If the child cannot eat around a dose, that dose is withheld (section 2.1).
It is drawn from a multiple-dose vial (40 mg/4 mL, 10 mg/mL) with a syringe small enough to measure the dose accurately (sections 2.2 and 3).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Step | Dose on the label |
|---|---|
| Starting dose | 0.04 mg/kg to 0.08 mg/kg of body weight twice daily |
| Step-up | If well-tolerated for at least one week, increase by 0.04 mg/kg of body weight per dose |
| Maximum dose | 0.12 mg/kg of body weight given twice daily |
The dose is individualized for each child. Blood sugar is checked before meals at the start and until a well-tolerated dose is set, and the dose is lowered if low blood sugar happens despite adequate food.
For syringes marked in units, the label converts mg/kg to units as: weight (kg) × dose (mg/kg) × 1 mL/10 mg × 100 units/1 mL = units per injection.
High-risk activities such as driving or exercise are avoided for 2 to 3 hours after a dose, especially at the start of treatment until a stable dose is reached.
Increlex is not used for growth once the growth plates (epiphyses) have closed.
If one or more doses are missed, the next doses are not increased to make up for them. The Patient Information adds that no extra dose is given, and that a dose is skipped if the child cannot eat.
More on this: missed a dose of Increlex.
In Dose Track you set up Increlex as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.