Targifor Uses

How old is patient?
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What is Targifor?

Targifor 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.

Targifor is to be given only by or under the direct supervision of your doctor.

Targifor indications

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Targifor® 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 Targifor® 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 Targifor® 10 (10%

Targifor 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 Targifor® 10 do not

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

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

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

Targifor description

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

Targifor dosage

Dosage Forms

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

Solution,

Intravenous, as hydrochloride [preservative free]:

Targifor 10: 10% (300 mL) [latex free]

Dosing: Adult

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

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

Targifor interactions

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

Targifor side effects

See also:
What are the possible side effects of Targifor?

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.

Targifor contraindications

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

Active ingredient matches for Targifor:

Arginine in Brazil.

Arginine aspartate in Brazil.


Unit description / dosage (Manufacturer)Price, USD
Tablet, Effervescent; Oral; Arginine Aspartate 1500 mg

List of Targifor substitutes (brand and generic names):

Manpos 20 tube 5 mL
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

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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