Drug information of cosyntropin

cosyntropin

Drug group:

Cosyntropin is a man-made form of a hormone called adrenocorticotropic hormone (ACTH)

Cosyntropin is used as part of a medical test called an ACTH stimulation test. This test can help your doctor diagnose adrenal gland disorders such as Addison's disease, Cushing syndrome, or hypopituitarism

cosyntropin

Mechanism of effect

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)

Drug indications

Screening of Adrenocortical Insufficiency

Dosage

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

<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

Drug contraindications

Hypersensitivity to this drug

Hypersensitivity to cosyntropin, synthetic ACTH, or to any excipients

Side effects

allergic reaction , flushing , Peripheral edema , itching , Rash

Flushing

Mild fever

Pruritus

Chronic pancreatitis

Hypersensitivity

Rash

Peripheral edema

Tachycardia

Bradycardia

Adrenal hemorrhage

Anaphylactic reaction

Interactions

Amphotericin B , Spironolactone , Estrogen , Primidone , Diazepam , Phenobarbital , Flunitrazepam , cyclopenthiazide , Amphotericin B Deoxycholate , Bumetanide , Torsemide , Chlorthalidone , Bendroflumethiazide , Methyclothiazide , Valproate sodium , Clonazepam , ethacrynic acid , Chlorothiazide , cortisone , Indapamide , Phenytoin , Furosemide , Metolazone , Nitrazepam , Hydrochlorothiazide , Hydrocortisone , Meningococcal conjugate vaccine

Corticosteroids 

Valproate Products

Alerts

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;

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

Points of recommendation

May administer by IV injection over 2 minutes or as an IV infusion over 4 to 8 hours

 May administer IM.

monitor patients for hypersensitivity reactions and treat as needed

Pregnancy level

C

C

Safety in pregnant women not established; there are no adequate and well controlled studies of cosyntropin in pregnant women

Breast feeding warning

 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

Related drugs

Tetracosactid , Metyrapone

Drug forms

Cortrosyn, Synthetic ACTH

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