Cosyntropin

Cosyntropin is a man-made form of a hormone called adrenocorticotropic hormone (ACTH) used as a  screening of adrenocortical insufficiency.

• Cosyntropin is available under the following different brand names: Cortrosyn, Synthetic ACTH

Common side effects of Cosyntropin include:

• Minor irritation at the injection site (redness, swelling, or a rash),
• Fast or slow heart rate,
• High blood pressure, and
• Swelling in the arms or legs

Serious side effects of Cosyntropin include:

• Hives,
• Difficulty breathing,
• Swelling of your face, lips, tongue, or throat,
• Itching,
• Red, swollen, blistered, or peeling skin with or without fever,
• Wheeze,
• Tightness in the chest or throat,
• Difficulty swallowing or talking,
• Unusual hoarseness,
• Headache,
• Dizziness,
• Fainting,
• Vision changes,
• Fast or slow heartbeats, and
• Swelling in the arms or legs

Rare side effects of Cosyntropin include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Powder for injection

• 0.25 mg/vial

Screening of Adrenocortical Insufficiency

Adult dosage

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

Pediatric dosage

• Children below 2 years
  • 0.125 mg Intravenous/Intramuscular
• Children above 2 years
  • 0.25-0.75 mg direct Intravenous/Intramuscular
  • May administer 0.25 mg as Intravenous infusion at 40 mcg/hour over 6 hours to provide a greater stimulus to the adrenal gland

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Cosyntropin has severe interactions with no other drugs.
• Cosyntropin has serious interactions with no other drugs.
• Cosyntropin has moderate interactions with no other drugs.
• Cosyntropin has minor interactions with the following drugs:
  • amphotericin B deoxycholate
  • bendroflumethiazide
  • bumetanide
  • chlorothiazide
  • chlorthalidone
  • cyclopenthiazide
  • ethacrynic acid
  • furosemide
  • hydrochlorothiazide
  • indapamide
  • methyclothiazide
  • metolazone
  • torsemide

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to cosyntropin, synthetic ACTH, or any excipients 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Cosyntropin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Cosyntropin?”

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 the patient; any condition that elevates or lowers cortisol binding globulin levels may increase or decrease plasma total cortisol levels, respectively

Pregnancy and Lactation

• Safety in pregnant women is not established; there are no adequate and well-controlled studies of cosyntropin in pregnant women; therapy should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus
• Lactation
  • Not known whether cosyntropin is excreted into human milk; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from cosyntropin, caution should be exercised when treatment is administered to a nursing woman