Corticotropin ACTH

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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

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