Tetracosactide

Synthetic ACTH Analog (melanocortin Peptide)Rx: PrescriptionCompound: Approved

Also known as: ACTH(1-24), Adrenocorticotropic hormone fragment, Cortrosyn, Cosyntropin, Synacthen, Synacthen Depot, Tetracosactide, Tetracosactrin

Educational Only — Not medical advice. Consult a qualified clinician before using any peptide.

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Summary

Tetracosactide (ACTH 1-24, cosyntropin) is a synthetic 24‑amino‑acid peptide identical to the N‑terminal portion of ACTH. It is FDA‑approved for diagnostic adrenal insufficiency testing and is used therapeutically in certain adrenal disorders.

Mechanism of Action

Agonist of melanocortin 2 receptor (MC2R) on adrenal cortex, stimulating cortisol synthesis and release

Routes of Administration

IntramuscularIntravenousSubcutaneous

Goals & Uses

  • anti‑inflammatory therapyImmunomodulationLow
  • Differentiation of primary vs. secondary adrenal insufficiencyDiagnosticHigh
  • Diagnosis of adrenocortical insufficiencyDiagnosticHigh
  • Therapeutic adrenal supportTherapeuticModerate
  • Infantile spasms (West syndrome)NeurologyModerate
  • Adrenal insufficiency diagnosisEndocrinology / DiagnosticsHigh
  • Multiple sclerosis relapseTherapeuticModerate
  • Treatment of inflammatory and autoimmune conditionsTherapeuticModerate

Contraindications

  • Hypersensitivity to tetracosactide or ACTHAllergy/ImmunologicHigh
  • Pregnancy (therapeutic use)ReproductiveModerate
  • Cushing's syndromeEndocrine DisorderHigh
  • Hypersensitivity to tetracosactideAllergyHigh
  • Systemic infections (untreated)InfectiousHigh
  • Active peptic ulcerGastrointestinalModerate
  • Adrenocortical hyperfunctionEndocrineHigh
  • Acute systemic fungal infectionInfectionModerate

Adverse Effects

  • HyperglycemiaMetabolicUncommonAbnormally high blood glucose
  • HypertensionCardiovascularUncommonHigh blood pressure
  • Injection site reactionsLocalCommon
  • HeadacheNeurologicUncommonPain in the head or upper neck
  • Fluid retention / edemaFluid / ElectrolyteCommon
  • Allergic/anaphylactic reactionImmunologicUncommon
  • Cushing's syndrome features (with prolonged therapeutic use)EndocrineUncommon
  • Transient hypercortisolismEndocrineCommon
  • Flushing / facial erythemaVascularCommon

Drug Interactions

  • Oral glucocorticoidsModerate
  • Live vaccinesHigh
  • CiclosporinModerate
  • Antidiabetic agentsModerate
  • CYP3A4 substratesLow
  • NSAIDsModerateMay increase renal risk in susceptible patients
  • Diuretics (potassium-wasting)Moderate

Population Constraints

  • PregnancyReproductive SafetyRelative
  • Pediatric patients (infants)AgeRelative
  • Pediatrics (<6 months)AgeRelative
  • Patients with osteoporosisMusculoskeletalRelative
  • Elderly patientsAgeRelative
  • Pregnant womenReproductiveRelative
  • Diabetic PatientsMetabolicRelative

Regulatory Status

  • European UnionApprovedApproved: diagnostic adrenal insufficiency testing, therapeutic adrenal supportMarketed as Synacthen.
  • United StatesApprovedApproved: diagnostic adrenal insufficiency testingCosyntropin injectable, prescription only.
  • United KingdomApprovedApproved: diagnostic adrenal insufficiency testingAvailable under NHS formularies.

Approved in the US (cosyntropin) for diagnostic use; approved in EU/UK (Synacthen) for both diagnostic and therapeutic indications.

Evidence & Sources

No sources recorded yet.

Frequently Asked Questions

What is Tetracosactide?

Tetracosactide (ACTH 1-24, cosyntropin) is a synthetic 24‑amino‑acid peptide identical to the N‑terminal portion of ACTH. It is FDA‑approved for diagnostic adrenal insufficiency testing and is used therapeutically in certain adrenal disorders.

What is Tetracosactide used for?

Tetracosactide is educationally associated with: anti‑inflammatory therapy, Differentiation of primary vs. secondary adrenal insufficiency, Diagnosis of adrenocortical insufficiency, Therapeutic adrenal support, Infantile spasms (West syndrome), Adrenal insufficiency diagnosis, Multiple sclerosis relapse, Treatment of inflammatory and autoimmune conditions. Educational only — not medical advice.

How is Tetracosactide administered?

Recorded routes of administration: Intramuscular, Intravenous, Subcutaneous.

What are the potential side effects of Tetracosactide?

Reported adverse effects include: Hyperglycemia, Hypertension, Injection site reactions, Headache, Fluid retention / edema, Allergic/anaphylactic reaction, Cushing's syndrome features (with prolonged therapeutic use), Transient hypercortisolism, Flushing / facial erythema. This list is not exhaustive — consult a qualified clinician.

Who should avoid Tetracosactide?

Recorded contraindications: Hypersensitivity to tetracosactide or ACTH, Pregnancy (therapeutic use), Cushing's syndrome, Hypersensitivity to tetracosactide, Systemic infections (untreated), Active peptic ulcer, Adrenocortical hyperfunction, Acute systemic fungal infection. Consult a qualified clinician before use.