Corticotropin ACTH

Corticotropin ACTH Brand Names

Acthar | H.P. Acthar

What is Corticotropin ACTH

Corticotropin ACTH is a parenteral preparation of adrenocorticotropic hormone (ACTH).

Corticotropin is a hormone naturally secreted by cells in the anterior lobe of the pituitary gland; corticotropin for commercial use is a highly purified sterile product extracted from the pituitary glands of pigs. In some situations, cosyntropin, a synthetic polypeptide containing the same first 24 amino acid sequence as natural corticotropin and with less antigenicity, has replaced corticotropin, primarily as an aid in the diagnosis of adrenocortical insufficiency.

Due to its anti-inflammatory effects, immunosuppressant properties, and effects on blood and lymphatic systems, corticotropin has been used as palliative treatment in conditions such as multiple sclerosis.

Corticotropin should not be used to treat primary adrenocortical insufficiency or congenital adrenogenital syndrome because it has been shown to be ineffective.

Corticotropin was initially approved by the FDA in 1950.

The drug is indicated for numerous autoimmune, allergic, and inflammatory conditions; however, the corticotropin repository injection is most commonly used in adult patients for multiple sclerosis; other indications are usually treated with prednisone, methylprednisolone or more commonly used systemic corticosteroids.

Corticotropin received FDA approval in October 2010 for the treatment of infantile spasms in infants and children less than 2 years of age.

Indications

1. ankylosing spondylitis
2. anterior segment inflammation
3. chorioretinitis
4. dermatomyositis
5. erythema multiforme
6. infantile spasms
7. iritis
8. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
9. keratitis
10. multiple sclerosis
11. nephrotic syndrome
12. optic neuritis
13. polymyositis
14. proteinuria
15. psoriatic arthritis
16. rheumatoid arthritis
17. sarcoidosis
18. serum sickness
19. Stevens-Johnson syndrome
20. systemic lupus erythematosus (SLE)

Side Effects

1. acne vulgaris
2. amenorrhea
3. anaphylactic shock
4. anorexia
5. appetite stimulation
6. avascular necrosis
7. bone fractures
8. candidiasis
9. cataracts
10. constipation
11. Cushing’s syndrome
12. depression
13. diarrhea
14. dizziness
15. dyspepsia
16. ecchymosis
17. EEG changes
18. emotional lability
19. erythema
20. esophagitis
21. euphoria
22. exophthalmos
23. fever
24. headache
25. heart failure
26. hirsutism
27. hyperglycemia
28. hyperhidrosis
29. hypernatremia
30. hypertension
31. hypocalcemia
32. hypokalemia
33. hypophosphatemia
34. hypothalamic-pituitary-adrenal (HPA) suppression
35. impaired wound healing
36. infection
37. injection site reaction
38. insomnia
39. intracranial bleeding
40. irritability
41. menstrual irregularity
42. metabolic alkalosis
43. myalgia
44. myopathy
45. nasal congestion
46. nausea
47. ocular hypertension
48. osteoporosis
49. pancreatitis
50. papilledema
51. petechiae
52. pruritus
53. pseudotumor cerebri
54. psychosis
55. rash
56. scarlatiniform exanthema
57. seizures
58. skin atrophy
59. skin hyperpigmentation
60. sodium retention
61. subdural hematoma
62. urticaria
63. vasculitis
64. vertigo
65. vomiting
66. weakness
67. weight gain
68. wheezing
69. withdrawal

Monitoring Parameters

• blood glucose
• blood pressure
• serum cortisol
• serum electrolytes

Contraindications

• adrenal insufficiency
• breast-feeding
• cardiac disease
• children
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• diverticulitis
• fungal infection
• geriatric
• heart failure
• herpes infection
• hypercortisolism
• hypernatremia
• hypertension
• hypokalemia
• hypothalamic-pituitary-adrenal (HPA) suppression
• hypothyroidism
• infants
• infection
• intravenous administration
• myasthenia gravis
• neonates
• ocular infection
• osteoporosis
• peptic ulcer disease
• porcine protein hypersensitivity
• postmenopausal females
• pregnancy
• psychosis
• renal impairment
• scleroderma
• seizure disorder
• surgery
• thromboembolic disease
• tuberculosis
• ulcerative colitis
• vaccination

Interactions

• Abatacept
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetazolamide
• Acetohexamide
• Adalimumab
• Albiglutide
• Aldesleukin, IL-2
• Alemtuzumab
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Altretamine
• Ambenonium Chloride
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Aminosalicylate sodium, Aminosalicylic acid
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Antithymocyte Globulin
• Antitumor antibiotics
• Argatroban
• Arsenic Trioxide
• Asparaginase Erwinia chrysanthemi
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atenolol; Chlorthalidone
• Atracurium
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Azathioprine
• Azilsartan; Chlorthalidone
• Basiliximab
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bepridil
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bivalirudin
• Bortezomib
• Brompheniramine; Carbetapentane; Phenylephrine
• Bupropion
• Bupropion; Naltrexone
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Carmustine, BCNU
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorambucil
• Chlorothiazide
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Choline Salicylate; Magnesium Salicylate
• Cimetidine
• Cisatracurium
• Citalopram
• Clindamycin
• Clofarabine
• Codeine; Phenylephrine; Promethazine
• Conivaptan
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Denileukin Diftitox
• Denosumab
• Desmopressin
• Dextran
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Digoxin
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dofetilide
• Doxacurium
• Droperidol
• Dulaglutide
• Echinacea
• Econazole
• Efalizumab
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Hydrochlorothiazide, HCTZ
• Ephedrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Estramustine
• Estrogens
• Exenatide
• Fluconazole
• Fluoxymesterone
• Fosinopril; Hydrochlorothiazide, HCTZ
• Gallium Ga 68 Dotatate
• Gemcitabine
• Gentamicin
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycerol Phenylbutyrate
• Guaifenesin; Phenylephrine
• Halofantrine
• Haloperidol
• Hemin
• Heparin
• Hetastarch
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Hydroxyurea
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibritumomab Tiuxetan
• Incretin Mimetics
• Indapamide
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Isoproterenol
• Isotretinoin
• L-Asparaginase Escherichia coli
• Levetiracetam
• Levomethadyl
• Linagliptin; Metformin
• Liraglutide
• Lixisenatide
• Lomustine, CCNU
• Loop diuretics
• Macimorelin
• Magnesium Salicylate
• Mannitol
• Mecasermin rinfabate
• Mecasermin, Recombinant, rh-IGF-1
• Meglitinides
• Melphalan
• Mepenzolate
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methacholine
• Methazolamide
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methoxsalen
• Methyclothiazide
• Metolazone
• Micafungin
• Mifepristone
• Mitoxantrone
• Mivacurium
• Moxifloxacin
• Muromonab-CD3
• Natalizumab
• Nateglinide
• Nelarabine
• Neostigmine
• Neuromuscular blockers
• Nicardipine
• Nonsteroidal antiinflammatory drugs
• Ondansetron
• Oxymetholone
• Pancuronium
• Pegaspargase
• Penicillamine
• Phenylephrine
• Phenylephrine; Promethazine
• Photosensitizing agents (topical)
• Physostigmine
• Pimozide
• Potassium
• Potassium Chloride
• Potassium Phosphate; Sodium Phosphate
• Potassium-sparing diuretics
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Propranolol
• Purine analogs
• Pyridostigmine
• Quetiapine
• Rapacuronium
• Regular Insulin
• Repaglinide
• Ritodrine
• Rituximab
• Rituximab; Hyaluronidase
• Rocuronium
• Salicylates
• Salsalate
• Sargramostim, GM-CSF
• Semaglutide
• SGLT2 Inhibitors
• Sodium Benzoate; Sodium Phenylacetate
• Sodium Chloride
• Sodium Phenylbutyrate
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Somatropin, rh-GH
• Succinylcholine
• Sulfonylureas
• Telbivudine
• Testosterone
• Thiazide diuretics
• Thiazolidinediones
• Thyroid hormones
• Tobramycin
• Tolazamide
• Tolbutamide
• Tositumomab
• Tranexamic Acid
• Trastuzumab; Hyaluronidase
• Tretinoin, ATRA
• Tuberculin Purified Protein Derivative, PPD
• Tubocurarine
• Vancomycin
• Vecuronium
• Vigabatrin
• Vinblastine
• Vincristine Liposomal
• Vorinostat
• Warfarin
• Zafirlukast
• Zileuton