What is Largex?
Largex injection is used to assess the function of the pituitary gland. It stimulates the pituitary gland to produce growth hormone for the diagnosis of certain conditions.
Largex is to be given only by or under the direct supervision of your doctor.
Largex indications
Largex® 10 is indicated as an intravenous stimulant to the pituitary for the release of
human growth hormone in patients where the measurement of pituitary reserve for HGH
can be of diagnostic usefulness. It can be used as a diagnostic aid in such conditions as
panhypopituitarism, pituitary dwarfism, chromophobe adenoma, postsurgical
craniopharyngioma, hypophysectomy, pituitary trauma, acromegaly, gigantism and
problems of growth and stature.
If the insulin hypoglycemia test has indicated a deficiency of pituitary reserve for HGH, a
test with Largex® 10 is advisable to confirm the negative response. This can be done
after a waiting period of one day. As patients may not respond to Largex® 10 (10%
Largex Hydrochloride Injection, USP) during the first test, the unresponsive patient should be tested again to confirm the negative result. A second test can be performed
after a waiting period of one day. Some patients who respond to Largex® 10 do not
respond to insulin and vice versa. The rate of false positive responses for Largex® 10 is
approximately 32%, and the rate of false negatives is approximately 27%.
Uses of Largex in details
Use: Labeled Indications
Diagnostic aid: As an intravenous (IV) stimulant to the pituitary for the release of human growth hormone (hGH) in patients in whom the measurement of pituitary reserve for hGH can be of diagnostic usefulness. Used as a diagnostic aid in such conditions as panhypopituitarism, pituitary dwarfism, chromophobe adenoma, postsurgical craniopharyngioma, hypophysectomy, pituitary trauma, acromegaly, gigantism, and problems of growth and stature.
Off Label Uses
Hyperammonemia (acute) associated with urea cycle disorders
Data from an uncontrolled open-label study conducted over a 25 year period supports the use of intravenous Largex (in combination with sodium benzoate, sodium phenylacetate and adequate caloric provision) for the treatment of acute hyperammonemia associated with urea-cycle disorders resulting in increased survival.
Based on the National Organization for Rare Disorders, the use of Largex is effective and recommended for the management of patients with this condition.
Oral products available in the US are often marketed as dietary supplements. When using these products, patients should take care to ensure that they are receiving pharmaceutical grade supplements of L-Largex and verify the formulation (free base vs Largex HCl). The National Urea Cycle Disorders Foundation cautions against using oral dietary supplements of Largex HCl (National Urea Cycles Disorder Foundation).
Largex description
An essential amino acid that is physiologically active in the L-form. [PubChem]
Largex dosage
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution,
Intravenous, as hydrochloride [preservative free]:
Largex 10: 10% (300 mL) [latex free]
Dosing: Adult
Diagnostic aid (pituitary function): Note: Dosing based on Largex hydrochloride product. IV: 30 g as a single dose
Hyperammonemia, acute (urea cycle disorders) (off-label use): Note: Dosing based on Largex hydrochloride product and on specific enzyme deficiency. Therapy should continue until ammonia levels are in normal range. If a loading dose is used, it should not be repeated. Largex dose may be adjusted downward if patient becomes hypotensive and/or when the exact enzyme deficiency is identified. Administer concomitantly with sodium benzoate and sodium phenylacetate along with dialysis (NORD 2012).
Weight-directed dosing:
Argininosuccinate synthetase (ASS, Citrullinemia) or Argininosuccinate lyase (ASL) deficiency: IV: Loading dose: 600 mg/kg followed by a continuous IV infusion of 600 mg/kg/day (NORD 2012)
Carbamyl phosphate synthetase (CPS), ornithine transcarbamylase (OTC) or N-acetylglutamate synthetase (NAGS) deficiency: IV: Loading dose: 200 mg/kg followed by a continuous IV infusion of 200 mg/kg/day (NORD 2012)
Unconfirmed/pending diagnosis: IV: Loading dose: 600 mg/kg followed by a continuous IV infusion of 600 mg/kg/day (NORD 2012); if ASS and ASL are excluded as diagnostic possibilities, reduce dose to 200 mg/kg/day
BSA-directed dosing:
Argininosuccinate synthetase (ASS, Citrullinemia) or Argininosuccinate lyase (ASL) deficiency: IV: Loading dose: 12 g/m/day in 3 to 4 divided doses
Largex interactions
Cyclosporine - L-Largex may counteract the antinaturetic effect of cyclosporin. Ibuprofen - L-Largex may increase the absorption of ibuprofen if taken concomitantly. Organic nitrates - L-Largex supplements theoretically may potentiate the effects of organic nitrates if taken concomitantly. Sildenafil citrate - Theoretically, L-Largex supplements taken concomitantly with sildenafil citrate, may potentiate the effects of the drug.
Largex side effects
See also:
What are the possible side effects of Largex?
Adverse reactions associated with 1670 infusions in premarketing studies were as
follows:
Non-specific side effects consisting of nausea, vomiting, headache, flushing, numbness
and local venous irritation were reported in approximately 3% of the patients.
One patient had an allergic reaction which was manifested as a confluent macular rash
with reddening and swelling of the hands and face. The rash subsided rapidly after the
infusion was terminated and 50 mg of diphenhydramine were administered. One patient
had an apparent decrease in platelet count from 150,000 to 60,000. One patient with a
history of acrocyanosis had an exacerbation of this condition following infusion of RGene
® 10.
Largex contraindications
Supplemental L-Largex is contraindicated in those with the rare genetic disorder argininemia. It is also contraindicated in those hypersensitive to any component of an Largex-containing preparation.
Active ingredient matches for Largex:
Arginine in India.
List of Largex substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| L-Arginine (New Zealand, Peru) | |
| L-arginine 1000 mg tablet | $ 0.07 |
| R-gene 10 vial | $ 0.04 |
| L-Arginine HCL Excelsior Pharmatech (Taiwan) | |
| L-Arginine Hydrochloride Sandoz (Canada) | |
| L-Arginine Knop (Chile) | |
| Laclorene (Argentina) | |
| Lacorene (Argentina) | |
| Leberam (Germany) | |
| Levargin | |
| Livercrom (Spain) | |
| Minophagen A | |
| Modumate | |
| Pan-Asténico (Portugal) | |
| Pargine (France, Luxembourg) | |
| Solution; Oral; L-Arginine L-Aspartate 500 mg / ml (Meda) | |
| Potenciator (Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama, Peru, Spain) | |
| Pu Luo Chuan (China) | |
| R-Gene (United States) | |
| Injectable; Injection; Arginine Hydrochloride 10 g / 100 ml | |
| 300 milliliter in 1 container | |
| R-gene injection, solution 10 g/100mL (Pharmacia and Upjohn Company (US)) | |
| Recuperex (Ecuador) | |
| Reforgan (Brazil) | |
| Resource Diabetishield (Hongkong) | |
| Resource Diabetishield / Orange twist 237 mL tetra pack | |
| Rocmaline Desodee | |
| Rocmaline desodée (France) | |
| Samjin Arginine (Vietnam) | |
| Samjin Arginine 200 mg x 1 Box | |
| Sangenor (Austria) | |
| Solution; Oral; Arginine Aspartate (Mundipharma) | |
| Sargenor (Belize, Bulgaria, Costa Rica, Dominican Republic, El Salvador, France, Guatemala, Haiti, Honduras, Latvia, Luxembourg, Nicaragua, Panama, Portugal, Romania, Tunisia, Vietnam) | |
| Solution; Oral; Arginine Aspartate 1 g / 5 ml (Meda) | |
| Solution; Oral; Arginine Aspartate 500 mg / 5 ml (Meda) | |
| Sargenor 5 mL x 20 tube (Meda) | |
| Sargenor 5 mL x 40 tube (Meda) | |
| Sargenor sans sucre | |
| Tablet, Chewable; Oral; Arginine Aspartate 1 g | |
| Tablet, Effervescent; Oral; Arginine Aspartate 1 g | |
| Sargisthene (Spain) | |
| Sorbenor (Spain) | |
| Spermargin (Italy) | |
| Sulfile (Portugal) | |
| Targifor (Brazil) | |
| Tablet, Effervescent; Oral; Arginine Aspartate 1500 mg (Sanofi-aventis) | |
| Tivomax-Darnitsa (Georgia) | |
| Tivortin (Georgia) | |
| vasologes protect (Germany) | |
| Viteron Forte (El Salvador, Guatemala, Honduras) | |
See 120 substitutes for Largex | |
Reviews
The results of a survey conducted on ndrugs.com for Largex are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Largex. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
No survey data has been collected yet1 consumer reported age
| Users | % | ||
|---|---|---|---|
| 16-29 | 1 | 100.0% | |
Consumer reviews
There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
