Ngenla Dosage/Direction for Use

Posology: The recommended dose is 0.66 mg/kg body weight administered once weekly by subcutaneous (SC) injection.
For patients switching from daily growth hormone medicinal products, the weekly therapy with NGENLA may be initiated on the day following their last daily injection.
Method of administration: NGENLA can be given in the abdomen, thighs, buttocks, or upper arms. The site of injection should be rotated weekly.
If more than one injection is required to deliver a complete dose, each injection should be administered at a different injection site.
Administer NGENLA once weekly, on the same day each week, at any time of the day.
Dose titration: NGENLA dose may be adjusted as necessary, based on growth velocity, adverse reactions, body weight and serum insulin-like growth factor 1 (IGF-1) concentrations. When monitoring for IGF-1, samples should always be drawn 4 days after the prior dose. IGF-1 values should be maintained below +2 standard deviation score (SDS).
Dose adjustments should be targeted to achieve average IGF-1 SDS levels in the normal range, i.e., between -2 and +2 (preferably close to 0 SDS). In patients whose serum IGF-1 concentrations exceed the mean reference value for their age and sex by more than 2 SDS, the dose of NGENLA should be reduced by 15%. More than one dose reduction may be required in some patients.
Missed dose: If a dose is missed, administer NGENLA as soon as possible within 3 days after the missed dose. If more than 3 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. In each case, patients can then resume their regular once weekly dosing scheduled.
Changing the dosing day: The day of weekly administration can be changed if necessary as long as the time between two doses is at least 3 days (>72 hours). After selecting a new dosing day, the once weekly dosing should be continued.
Refer to the Instructions for Use under Patient Counselling Information for complete administration instructions.