COSYNTROPIN
(Cortrosyn, Synacthen Depot, synthetic corticotropin, synthetic ACTH, tetracosactide)Standard Prescription
Cortrosyn __mg IV/IM x 1 dose
Synacthen __mg IM__(frequency) (__mg/kg/dose)
Synacthen __mg IM__(frequency) (__mg/kg/dose)
Dosages
*High-Dose ACTH Stimulation Test: (use Cortrosyn)
250 mcg IV/IM
*Low-Dose ACTH Stimulation Test: (use Cortrosyn)
1 mcg IV
Infantile Spasms: (use Synacthen Depot)
Initial (low dose): 0.03 mg/kg IM every 2 days x 2 weeks
If no response, use high dose: 0.06 mg/kg IM every 2 days x 2 weeks, then reassess
250 mcg IV/IM
*Low-Dose ACTH Stimulation Test: (use Cortrosyn)
1 mcg IV
Infantile Spasms: (use Synacthen Depot)
Initial (low dose): 0.03 mg/kg IM every 2 days x 2 weeks
If no response, use high dose: 0.06 mg/kg IM every 2 days x 2 weeks, then reassess
Mechanism of Action
synthetic ACTH
Forms Supplied
injection:
Cortrosyn: 0.25 mg/mL
Synacthen Depot: 1 mg/mL
Acthar gel (=repository corticotropin inj) 80 IU/mL; 5 mL vial ($21,000 per vial): available only through the Special Access Program.
Cortrosyn: 0.25 mg/mL
Synacthen Depot: 1 mg/mL
Acthar gel (=repository corticotropin inj) 80 IU/mL; 5 mL vial ($21,000 per vial): available only through the Special Access Program.
Comments
1 mg = 100 IU (Cortrosyn and Synacthen Depot).
Synacthen Depot & Acthar gel are for IM use only.
40 IU Acthar gel daily = 0.5 mg Synacthen Depot every other day.
Common adverse effects include: hypertension (which may require treatment), weight gain, irritability, gastric irritation, electrolyte imbalance.
*Refer to BCCH Endocrine Test Protocols.
Please note: Acthar gel and Synacthen Depot may be difficult to procure.
Synacthen Depot & Acthar gel are for IM use only.
40 IU Acthar gel daily = 0.5 mg Synacthen Depot every other day.
Common adverse effects include: hypertension (which may require treatment), weight gain, irritability, gastric irritation, electrolyte imbalance.
*Refer to BCCH Endocrine Test Protocols.
Please note: Acthar gel and Synacthen Depot may be difficult to procure.
References
4, 32, 44, 162, 682, 683
Last Edited
2022-06-16 17:37:34