Corticotropin
Also known as: ACTH, Acthar, Adrenocorticotropic hormone, Corticotrophin, Corticotropin, Cosyntropin, H.P. Acthar Gel, Repository corticotropin injection, Synacthen
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Summary
Corticotropin (ACTH) is a peptide hormone used therapeutically to stimulate adrenal cortisol production and diagnostically to assess adrenal reserve.
Mechanism of Action
Activates melanocortin 2 receptor (MC2R) on adrenal cortical cells, stimulating synthesis and release of cortisol and other glucocorticoids.
Routes of Administration
Goals & Uses
- Manage multiple‑sclerosis relapseTherapeuticModerate
- Nephrotic syndromeNephrologyModerate
- Infantile spasms (West syndrome)NeurologyHigh
- Control infantile spasmsTherapeuticHigh
- Adrenal insufficiency diagnosisEndocrinology / DiagnosticsHigh
- Acute gout flareRheumatologyModerate
- Rheumatic and collagen disordersRheumatology / ImmunologyModerate
- Stimulate adrenal cortisol production in adrenal insufficiencyTherapeuticModerate
- Diagnostic adrenal function testingDiagnosticHigh
- Multiple sclerosis acute exacerbationNeurology / ImmunologyModerate
Contraindications
- Known hypersensitivity to ACTH or formulation componentsAllergyHigh
- Live or live-attenuated vaccinesImmunologyHigh
- Systemic fungal infectionInfectionModerate
- Adrenocortical insufficiency or hyperfunctionEndocrinologyHigh
- OsteoporosisMusculoskeletalModerate
- SclerodermaAutoimmuneHigh
- Systemic fungal infectionsInfectious DiseaseHigh
- Uncontrolled hypertensionCardiovascularModerate
Adverse Effects
- EdemaFluid BalanceUncommonSwelling from fluid retention
- Cushingoid appearance (weight gain, moon face)EndocrineUncommon
- HypokalemiaElectrolyteCommon
- HyperglycemiaMetabolicCommonAbnormally high blood glucose
- HypertensionCardiovascularCommonHigh blood pressure
- Injection site pain/rednessLocalCommon
- Immunosuppression / increased infection riskImmunologyCommon
- HPA axis suppressionEndocrineCommon
- Skin hyperpigmentationDermatologicUncommon
- Cushing's syndrome / hypercortisolismEndocrineCommon
Drug Interactions
- NSAIDs (e.g., aspirin, ibuprofen)Moderate
- CYP3A4 inhibitors (e.g., ketoconazole)Moderate
- Vaccines (live)High
- Concurrent glucocorticoidsHigh
- Diuretics (thiazides, loop diuretics)Moderate
- Antidiabetic agents (insulin, oral hypoglycemics)Moderate
- Anticoagulants (warfarin)Moderate
Population Constraints
- Patients with active or latent tuberculosisInfectious DiseaseRelative
- PregnancyReproductive SafetyRelative
- ElderlyAgeRelative
- Pediatric infants (≤2 months) for infantile spasmsAgeAbsolute
- Pediatric patients (neonates/infants)PediatricRelative
- Patients with diabetes mellitusMetabolicRelative
- Elderly patientsAgeRelative
- Pregnant womenReproductiveRelative
Regulatory Status
- European UnionUnapprovedACTH not marketed as a therapeutic product; used off‑label in some countries.
- United StatesApprovedApproved: infantile spasms, multiple sclerosis relapse, diagnostic adrenal testingACTH gel (H.P. Acthar Gel) and cosyntropin 1‑24 are FDA‑approved.
- United KingdomUnapprovedNo licensed ACTH product; limited clinical use.
FDA‑approved ACTH gel (H.P. Acthar Gel) for infantile spasms, multiple‑sclerosis relapse, and certain inflammatory disorders; synthetic ACTH 1‑24 (cosyntropin) approved for diagnostic adrenal testing.
Evidence & Sources
No sources recorded yet.
Frequently Asked Questions
What is Corticotropin?
Corticotropin (ACTH) is a peptide hormone used therapeutically to stimulate adrenal cortisol production and diagnostically to assess adrenal reserve.
What is Corticotropin used for?
Corticotropin is educationally associated with: Manage multiple‑sclerosis relapse, Nephrotic syndrome, Infantile spasms (West syndrome), Control infantile spasms, Adrenal insufficiency diagnosis, Acute gout flare, Rheumatic and collagen disorders, Stimulate adrenal cortisol production in adrenal insufficiency, Diagnostic adrenal function testing, Multiple sclerosis acute exacerbation. Educational only — not medical advice.
How is Corticotropin administered?
Recorded routes of administration: Intramuscular, Intravenous, Subcutaneous.
What are the potential side effects of Corticotropin?
Reported adverse effects include: Edema, Cushingoid appearance (weight gain, moon face), Hypokalemia, Hyperglycemia, Hypertension, Injection site pain/redness, Immunosuppression / increased infection risk, HPA axis suppression, Skin hyperpigmentation, Cushing's syndrome / hypercortisolism. This list is not exhaustive — consult a qualified clinician.
Who should avoid Corticotropin?
Recorded contraindications: Known hypersensitivity to ACTH or formulation components, Live or live-attenuated vaccines, Systemic fungal infection, Adrenocortical insufficiency or hyperfunction, Osteoporosis, Scleroderma, Systemic fungal infections, Uncontrolled hypertension. Consult a qualified clinician before use.