Comparative Pharmacology
Head-to-head clinical analysis: ACTHAR GEL AUTOINJECTOR versus COSYNTROPIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTHAR GEL AUTOINJECTOR versus COSYNTROPIN.
ACTHAR GEL (AUTOINJECTOR) vs COSYNTROPIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACTHAR Gel (repository corticotropin injection) acts primarily by stimulating the adrenal cortex to secrete corticosteroids (cortisol, corticosterone, and aldosterone), which exert anti-inflammatory, immunosuppressive, and antiproliferative effects. The exact mechanism in specific indications (e.g., infantile spasms) is not fully understood but may involve modulation of the hypothalamic-pituitary-adrenal axis and direct effects on the central nervous system.
Synthetic adrenocorticotropic hormone (ACTH) analog that stimulates adrenal cortex to secrete cortisol, corticosterone, and androgens.
Initial: 40-80 units intramuscularly or subcutaneously every 24-48 hours; maintenance: 20-40 units intramuscularly or subcutaneously every 48 hours. Titrate based on response.
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
The terminal half-life of exogenously administered ACTH is approximately 15 minutes; however, the duration of adrenal cortisol stimulation persists for 6-12 hours after IM administration due to prolonged absorption from the gel formulation.
Terminal elimination half-life is approximately 15 minutes; rapid clearance requires continuous infusion or frequent dosing for sustained effect.
ACTH (corticotropin) is metabolized by tissue peptidases; renal excretion accounts for <5% of unchanged drug. Biliary/fecal elimination is negligible.
Primarily renal; >90% of dose excreted unchanged in urine; negligible biliary/fecal elimination.
Category C
Category C
Corticotropin
Corticotropin