Comparative Pharmacology
Head-to-head clinical analysis: ACTHAR versus COSYNTROPIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTHAR versus COSYNTROPIN.
ACTHAR vs COSYNTROPIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ACTHAR (repository corticotropin injection) is a purified adrenocorticotropic hormone (ACTH) analogue that stimulates the adrenal cortex to release cortisol, corticosterone, and aldosterone. It also has glucocorticoid and mineralocorticoid effects, and is thought to exert anti-inflammatory and immunosuppressive effects through melanocortin receptor activation, independent of adrenal steroid production.
Synthetic adrenocorticotropic hormone (ACTH) analog that stimulates adrenal cortex to secrete cortisol, corticosterone, and androgens.
ACTHAR (repository corticotropin injection) 80 U/mL; for acute exacerbation of multiple sclerosis: 80-120 U IM daily for 2-3 weeks. For infantile spasms: 150 U/m² IM daily divided twice daily for 2 weeks, then taper.
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
15-20 minutes (intravenous); clinical duration longer due to sustained adrenal stimulation.
Terminal elimination half-life is approximately 15 minutes; rapid clearance requires continuous infusion or frequent dosing for sustained effect.
Primarily renal; <5% unchanged in urine; extensive metabolism via proteolysis.
Primarily renal; >90% of dose excreted unchanged in urine; negligible biliary/fecal elimination.
Category C
Category C
Corticotropin
Corticotropin