Pan-Asténico Uses

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What is Pan-Asténico?

Pan-Asténico 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.

Pan-Asténico is to be given only by or under the direct supervision of your doctor.

Pan-Asténico indications

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Pan-Asténico® 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 Pan-Asténico® 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 Pan-Asténico® 10 (10%

Pan-Asténico 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 Pan-Asténico® 10 do not

respond to insulin and vice versa. The rate of false positive responses for Pan-Asténico® 10 is

approximately 32%, and the rate of false negatives is approximately 27%.

Uses of Pan-Asténico in details

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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 Pan-Asténico (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 Pan-Asténico 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-Pan-Asténico and verify the formulation (free base vs Pan-Asténico HCl). The National Urea Cycle Disorders Foundation cautions against using oral dietary supplements of Pan-Asténico HCl (National Urea Cycles Disorder Foundation).

Pan-Asténico description

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An essential amino acid that is physiologically active in the L-form. [PubChem]

Pan-Asténico dosage

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution,

Intravenous, as hydrochloride [preservative free]:

Pan-Asténico 10: 10% (300 mL) [latex free]

Dosing: Adult

Diagnostic aid (pituitary function): Note: Dosing based on Pan-Asténico hydrochloride product. IV: 30 g as a single dose

Hyperammonemia, acute (urea cycle disorders) (off-label use): Note: Dosing based on Pan-Asténico 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. Pan-Asténico 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

Pan-Asténico interactions

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Cyclosporine - L-Pan-Asténico may counteract the antinaturetic effect of cyclosporin. Ibuprofen - L-Pan-Asténico may increase the absorption of ibuprofen if taken concomitantly. Organic nitrates - L-Pan-Asténico supplements theoretically may potentiate the effects of organic nitrates if taken concomitantly. Sildenafil citrate - Theoretically, L-Pan-Asténico supplements taken concomitantly with sildenafil citrate, may potentiate the effects of the drug.

Pan-Asténico side effects

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What are the possible side effects of Pan-Asténico?

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.

Pan-Asténico contraindications

Supplemental L-Pan-Asténico is contraindicated in those with the rare genetic disorder argininemia. It is also contraindicated in those hypersensitive to any component of an Pan-Asténico-containing preparation.

Active ingredient matches for Pan-Asténico:

Arginine in Portugal.


List of Pan-Asténico substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
L-arginine 1000 mg tablet$ 0.07
R-gene 10 vial$ 0.04
Solution; Oral; L-Arginine L-Aspartate 500 mg / ml (Meda)
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))
Resource Diabetishield / Orange twist 237 mL tetra pack
Samjin Arginine 200 mg x 1 Box
Solution; Oral; Arginine Aspartate (Mundipharma)
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)
Tablet, Chewable; Oral; Arginine Aspartate 1 g
Tablet, Effervescent; Oral; Arginine Aspartate 1 g
Tablet, Effervescent; Oral; Arginine Aspartate 1500 mg (Sanofi-aventis)

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