Comparative Pharmacology
Head-to-head clinical analysis: ACTH versus ACTHAR GEL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTH versus ACTHAR GEL.
ACTH vs ACTHAR GEL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACTH (corticotropin) stimulates the adrenal cortex to release cortisol, corticosterone, aldosterone, and androgenic steroids. It binds to the melanocortin 2 receptor (MC2R) in the adrenal gland, activating adenylyl cyclase and increasing intracellular cAMP.
Stimulates adrenal cortex to secrete cortisol, corticosterone, and aldosterone; also exerts extra-adrenal effects via melanocortin receptors.
40-80 units intramuscularly or subcutaneously every 24-72 hours for chronic conditions; 25 units intravenously over 8 hours for diagnostic use.
Initial: 40-80 Units intramuscularly or subcutaneously every 24-48 hours; maintenance: 40 Units intramuscularly or subcutaneously every 24-72 hours.
None Documented
None Documented
15 minutes (intravenous); rapid clearance due to enzymatic degradation; clinical effect persists 2-4 hours due to steroidogenesis
Terminal elimination half-life approximately 2–3 hours for corticotropin component; repository formulation (gel) extends to 15–20 hours due to slow absorption.
Renal: <5% unchanged; hepatic metabolism via proteolysis; <1% biliary/fecal
Renal metabolism and excretion (primarily as inactive metabolites); <5% unchanged in urine. Biliary/fecal excretion negligible.
Category C
Category C
Corticotropin
Corticotropin