Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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.
Adverse Effects
Frequency Not Defined
Flushing
Mild fever
Pruritus
Chronic pancreatitis
Hypersensitivity
Rash
Peripheral edema
Tachycardia
Bradycardia
Adrenal hemorrhage
Postmarketing Reports
Anaphylactic reaction
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
Diagnostic inaccuracies
- 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; for example, cortisol binding globulin levels can be low in cirrhosis or nephrotic syndrome
- Cortisone or hydrocortisone use might falsely elevate or, in a paradoxical response, lower plasma cortisol levels; spironolactone use may result in falsely elevated cortisol levels; patients receiving cortisone, hydrocortisone or spironolactone should omit their pre-test doses on the day selected for testing
- Use of synthetic glucocorticoid preparations (oral, inhaled, or injectable) might suppress plasma cortisol levels
- Use of estrogen-containing drugs increases cortisol binding globulin levels which can elevate plasma total cortisol levels; to ensure accuracy of plasma total cortisol levels, discontinue estrogen-containing drugs 4-6 weeks prior to testing to allow cortisol binding globulin levels to return to levels within reference range; alternatively, concomitant measurement of cortisol binding globulin at time of testing can be done; if cortisol binding globulin levels are elevated, plasma total cortisol levels are considered inaccurate
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.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)
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
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Cortrosyn injection - | 0.25 mg vial |  | |
| cosyntropin injection - | 0.25 mg vial |  | |
| cosyntropin injection - | 0.25 mg vial |  | |
| cosyntropin injection - | 0.25 mg vial |  | |
| cosyntropin injection - | 0.25 mg vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
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) 2023 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.
Formulary
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