cosyntropin (Rx)

Brand and Other Names:Cortrosyn, Synthetic ACTH
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 0.25mg/vial

Screening of Adrenocortical Insufficiency

0.25-0.75 mg direct IV/IM

May administer 0.25 mg as IV infusion at 40 mcg/hr over 6 hr to provide greater stimulus to the adrenal gland

Dosage Forms & Strengths

powder for injection

  • 0.25mg/vial

Screening of Adrenocortical Insufficiency

<2 years

  • 0.125 mg IV/IM

≥2 years

  • 0.25-0.75 mg direct IV/IM
  • May administer 0.25 mg as IV infusion at 40 mcg/hr over 6 hr to provide greater stimulus to the adrenal gland

Duchenne Muscular Dystrophy (Orphan)

Orphan designation for treatment of Duchenne muscular dystrophy

Sponsor

  • Mallinckrodt ARD Inc; 675 McDonnell Boulevard; Hazelwood, Missouri 63042

Infantile Spasms (Orphan)

Orphan designation for treatment of infantile spasms as monotherapy or in combination with vigabatrin

Sponsor

  • West Therapeutic Development, LLC; 540 Ziegler Drive; Grayslake, Illinois 60030
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Interactions

Interaction Checker

and cosyntropin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (0)

                  Minor (13)

                  • amphotericin B deoxycholate

                    amphotericin B deoxycholate, cosyntropin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential for hypokalemia.

                  • bendroflumethiazide

                    cosyntropin, bendroflumethiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • bumetanide

                    cosyntropin, bumetanide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • chlorothiazide

                    cosyntropin, chlorothiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • chlorthalidone

                    cosyntropin, chlorthalidone. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • cyclopenthiazide

                    cosyntropin, cyclopenthiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • ethacrynic acid

                    cosyntropin, ethacrynic acid. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • furosemide

                    cosyntropin, furosemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • hydrochlorothiazide

                    cosyntropin, hydrochlorothiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • indapamide

                    cosyntropin, indapamide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • methyclothiazide

                    cosyntropin, methyclothiazide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • metolazone

                    cosyntropin, metolazone. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

                  • torsemide

                    cosyntropin, torsemide. pharmacodynamic synergism. Minor/Significance Unknown. Possible enhanced electrolyte loss.

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                  Adverse Effects

                  Frequency Not Defined

                  Flushing

                  Mild fever

                  Pruritus

                  Chronic pancreatitis

                  Hypersensitivity

                  Rash

                  Peripheral edema

                  Tachycardia

                  Bradycardia

                  Adrenal hemorrhage

                  Postmarketing Reports

                  Anaphylactic reaction

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                  Warnings

                  Contraindications

                  Hypersensitivity to cosyntropin, synthetic ACTH, or to any excipients

                  Cautions

                  Use caution in patients with gastrointestinal disease, cardiovascular disease, hepatic disease, infections, myasthenia gravis, ocular disease, psychiatric disturbances, osteoporosis, renal disease, thyroid disease

                  Reactions including anaphylaxis are possible; monitor patients for hypersensitivity reactions and treat as needed

                  Accuracy of diagnosis can be complicated by concomitant medications taken by patient; any condition that elevates or lowers cortisol binding globulin levels may increase or decrease plasma total cortisol levels, respectively

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                  Pregnancy & Lactation

                  Pregnancy

                  Safety in pregnant women not established; there are no adequate and well controlled studies of cosyntropin in pregnant women; therapy should be used during pregnancy only if potential benefit justifies potential risk to fetus

                  Lactation

                  Not known whether cosyntropin is excreted into human milk; because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing infants from cosyntropin, caution should be exercised when treatment is administered to a nursing woman

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Mimics natural ACTH; stimulates adrenal cortex to secrete adrenal steroids (cortisone and hydrocortisone), androgenic substances, and aldosterone

                  Pharmacokinetics

                  Duration: IM: <4 hr

                  Onset: IM: 1 hr

                  Time to peak plasma concentration: Within 1 hr (IM, IV push)

                  Bioavailability: Well absorbed from parenteral route

                  Vd: 43%

                  Half-life: 7 min

                  Metabolism: Unknown

                  Excretion: Urine

                  Absorption: Rapid (IM)

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                  Administration

                  IV Incompatibilities

                  Compatibility of cosyntropin for injection with other drugs depends on several factors (eg, concentration of the drugs, specific diluents used, resulting pH, temperature)

                  IV/IM Administration

                  Administer by IM or IV injection or by IV infusion

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                  Images

                  BRAND FORM. UNIT PRICE PILL IMAGE
                  cosyntropin injection
                  -
                  0.25 mg vial
                  cosyntropin injection
                  -
                  0.25 mg vial
                  cosyntropin injection
                  -
                  0.25 mg vial
                  cosyntropin injection
                  -
                  0.25 mg vial
                  Cortrosyn injection
                  -
                  0.25 mg vial

                  Copyright © 2010 First DataBank, Inc.

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                  Patient Handout

                  Patient Education
                  cosyntropin injection

                  NO MONOGRAPH AVAILABLE AT THIS TIME

                  USES: Consult your pharmacist.

                  HOW TO USE: Consult your pharmacist.

                  SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                  PRECAUTIONS: Consult your pharmacist.

                  DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

                  OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                  NOTES: No monograph available at this time.

                  MISSED DOSE: Consult your pharmacist.

                  STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                  Information last revised July 2016. Copyright(c) 2021 First Databank, Inc.

                  IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                  Formulary

                  FormularyPatient Discounts

                  Adding plans allows you to compare formulary status to other drugs in the same class.

                  To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                  Adding plans allows you to:

                  • View the formulary and any restrictions for each plan.
                  • Manage and view all your plans together – even plans in different states.
                  • Compare formulary status to other drugs in the same class.
                  • Access your plan list on any device – mobile or desktop.

                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.