Comparative Pharmacology
Head-to-head clinical analysis: ACTH versus COSYNTROPIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTH versus COSYNTROPIN.
ACTH vs COSYNTROPIN
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.
Synthetic adrenocorticotropic hormone (ACTH) analog that stimulates adrenal cortex to secrete cortisol, corticosterone, and androgens.
40-80 units intramuscularly or subcutaneously every 24-72 hours for chronic conditions; 25 units intravenously over 8 hours for diagnostic use.
250 mcg to 2500 mcg intramuscularly or intravenously, with 250 mcg being the most commonly used dose for cosyntropin stimulation test; frequency as needed per test protocol.
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 is approximately 15 minutes; rapid clearance requires continuous infusion or frequent dosing for sustained effect.
Renal: <5% unchanged; hepatic metabolism via proteolysis; <1% biliary/fecal
Primarily renal; >90% of dose excreted unchanged in urine; negligible biliary/fecal elimination.
Category C
Category C
Corticotropin
Corticotropin