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Acthar (ACTH)

Indications: 1) acute exacerbation of multiple sclerosis 2) diagnostic aid in adrenocortical insufficiency 3) severe muscle weakness in myasthenia gravis Dosage: 1) multiple sclerosis: 80-120 units/day for 2-3 weeks 2) diagnostic aid: a) 20 units IM/SC QID b) 10-25 units in 500 mL D5W over 8 hours Injection: 25 & 40 units/vial Injection: (repository) 40 & 80 units/mL (5 mL) Pharmacokinetics: - 1/2 life in blood of ACTH is 10 minutes Adverse effects: 1) common (> 10%) - increased appetite, insomnia, indigestion, nervousness 2) less common (1-10%) - cataracts, hyperglycemia, diabetes mellitus, hirsuitism, joint pain, epistaxis 3) uncommon (< 1%) - seizures, mood swings, headache, skin atrophy, bruising, hyperpigmentation, acne, amenorrhea, Na+ & H2O retention, Cushing's syndrome, bone growth suppression, abdominal distension, ulcerative esophagitis, pancreatitis, muscle wasting, hypersensitivity reactions, delirium, hallucinations, euphoria Mechanism of action: - ACTH induces secretion of corticoteroids (cortisol, DHEA) from adrenal cortex

Related

ACTH (corticotropin) in plasma adrenocorticotropic hormone receptor; ACTH receptor; ACTH-R; adrenocorticotropin receptor; melanocortin receptor 2; MC2-R (MC2R ACTHR) corticotropin-releasing factor; corticoliberin; CRF; corticotropin-releasing hormone (CRH) cosyntropin (Cortrosyn) ectopic ACTH syndrome pituitary adenoma/ACTH secreting

General

adrenocorticotropic hormone; corticotropin; adrenocorticotropin (ACTH) endocrine agent

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Department of Veterans Affairs, VA National Formulary