Comparative Pharmacology
Head-to-head clinical analysis: ACTHAR GEL versus COSYNTROPIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTHAR GEL versus COSYNTROPIN.
ACTHAR GEL vs COSYNTROPIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Stimulates adrenal cortex to secrete cortisol, corticosterone, and aldosterone; also exerts extra-adrenal effects via melanocortin receptors.
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: 40 Units intramuscularly or subcutaneously every 24-72 hours.
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
Terminal elimination half-life approximately 2–3 hours for corticotropin component; repository formulation (gel) extends to 15–20 hours due to slow absorption.
Terminal elimination half-life is approximately 15 minutes; rapid clearance requires continuous infusion or frequent dosing for sustained effect.
Renal metabolism and excretion (primarily as inactive metabolites); <5% unchanged in urine. Biliary/fecal excretion negligible.
Primarily renal; >90% of dose excreted unchanged in urine; negligible biliary/fecal elimination.
Category C
Category C
Corticotropin
Corticotropin