cosyntropin (Rx)

Brand and Other Names:Cortrosyn, Synthetic ACTH
  • Print

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
Next:

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 
            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Flushing

            Mild fever

            Pruritus

            Chronic pancreatitis

            Hypersensitivity

            Rash

            Peripheral edema

            Tachycardia

            Bradycardia

            Adrenal hemorrhage

            Postmarketing Reports

            Anaphylactic reaction

            Previous
            Next:

            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

            Previous
            Next:

            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.

            Previous
            Next:

            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)

            Previous
            Next:

            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

            Previous
            Next:

            Images

            Previous
            Next:

            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.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.