Usage
- Recombinant human epidermal growth factor (rhEGF) is prescribed to enhance wound healing in various clinical settings, notably diabetic foot ulcers and burns (first and second degree). It can also be used for skin grafts and bedsores.
- Pharmacological Classification: Growth factor.
- Mechanism of Action: rhEGF binds to epidermal growth factor receptors (EGFR) on the cell surface, stimulating cell proliferation, differentiation, and migration, thereby accelerating the healing process. It also promotes angiogenesis (formation of new blood vessels) and protects cells from oxidative stress.
Alternate Names
- rhEGF
- EGF
- Human recombinant EGF
- Regen-D (brand name)
- Rhgf (brand name)
How It Works
- Pharmacodynamics: rhEGF exerts its therapeutic effect by binding to EGFR, a tyrosine kinase receptor. This binding triggers intracellular signaling cascades leading to increased DNA synthesis, cell division, and tissue regeneration.
- Pharmacokinetics: rhEGF is primarily administered topically. Systemic absorption after topical application is minimal. When administered intravenously or subcutaneously (as used in certain research settings), it is cleared rapidly. Elimination pathways are not fully elucidated but are thought to involve receptor-mediated endocytosis and subsequent lysosomal degradation. Elimination pathways have not been observed in renal/hepatic excretion, metabolism by CYP enzymes, etc.
- Mode of Action: rhEGF binds to EGFR, leading to receptor dimerization and autophosphorylation. This activates downstream signaling pathways such as MAPK and PI3K/Akt, which regulate gene expression related to cell growth, survival, and migration.
Dosage
Standard Dosage
Adults:
Topical application of rhEGF gel is common, with various concentrations available (e.g., 60 µg/g, 150 µg/g). The gel is typically applied to the cleansed wound twice daily until healing is complete. Treatment may be continued for 2-3 weeks after the wound heals.
Children:
Pediatric dosing guidelines are not well-established and should be determined by a physician based on individual patient needs.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically required.
- Patients with Renal Impairment: No dose adjustment needed.
- Patients with Hepatic Dysfunction: No dose adjustment needed.
- Patients with Comorbid Conditions: Dosage adjustments may be needed based on the specific comorbidity.
Clinical Use Cases
Dosage for all cases generally follows standard adult dosing guidelines.
Side Effects
Common Side Effects
- Mild skin irritation or pain at the application site.
Rare but Serious Side Effects
- Allergic reactions (including anaphylaxis).
Long-Term Effects
- No significant long-term adverse effects have been reported.
Contraindications
- Hypersensitivity to rhEGF or any component of the formulation.
- Pregnancy and lactation.
- Patients receiving immunosuppressive or immune stimulant therapy.
- Immune compromised individuals.
Drug Interactions
- Concomitant use with other growth factors is not recommended.
- No other significant drug interactions are known.
Pregnancy and Breastfeeding
- Pregnancy Safety Category: Contraindicated.
- rhEGF is contraindicated during pregnancy and breastfeeding due to potential risks to the fetus or neonate.
Drug Profile Summary
- Mechanism of Action: Binds to EGFR, promoting cell growth and wound healing.
- Side Effects: Generally well-tolerated; mild skin irritation may occur. Rare but serious side effects include allergic reactions.
- Contraindications: Hypersensitivity, pregnancy, lactation, immunosuppression.
- Drug Interactions: Avoid concomitant use with other growth factors.
- Pregnancy & Breastfeeding: Contraindicated.
- Dosage: Topical application twice daily until healed. Various concentrations available.
- Monitoring Parameters: Wound size, healing progress, signs of infection or allergic reactions.
Popular Combinations
- No specific drug combinations are routinely recommended.
Precautions
- Assess for hypersensitivity before initial use.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Recombinant Human Epidermal Growth Factor?
A: Topical application twice daily to the cleansed wound, using a concentration determined by a physician (e.g., 60 µg/g, 150 µg/g).
Q2: What are the common side effects?
A: Mild skin irritation or pain at the application site.
Q3: Is rhEGF safe to use during pregnancy?
A: No, rhEGF is contraindicated during pregnancy and breastfeeding.
Q4: How does rhEGF work?
A: It binds to EGFR, stimulating cell growth, differentiation, and wound healing.
Q5: What are the contraindications for rhEGF use?
A: Hypersensitivity, pregnancy, lactation, immunosuppression, immune compromised individuals.
Q6: Can rhEGF be used with other growth factors?
A: Concomitant use with other growth factors is not recommended.
Q7: What types of wounds can rhEGF be used on?
A: Diabetic foot ulcers, burns (first and second degree), skin grafts, and bedsores.
Q8: How long should rhEGF treatment be continued?
A: Until the wound is completely healed, and potentially for 2-3 weeks beyond that point as directed by the physician.
Q9: Are there any special dosage considerations for elderly patients?
A: No specific dosage adjustments are typically necessary for the elderly.
