Corticotropin
- Atc Codes:H01AA01
- CAS Codes:9002-60-2
- PHARMGKB ID:9002-60-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
North America
USA: H.P. Acthar Gel.
Latin America
Argentina: Acthelea.
Drug combinations
Chemistry
Corticotropin, Repository: C~207~H~308~N~56~O~58~S. Mw: 4541.07. Adrenocorticotropic hormone, human. CAS-9002-60-2.
Pharmacologic Category
Hormones and Synthetic Substitutes; Pituitary. Diagnostic Agents; Adrenocortical Insufficiency. Systemic Corticosteroid. (ATC-Code: H01AA01).
Mechanism of action
Stimulates the adrenal cortex to secrete cortisol, corticosterone, aldosterone, and other weakly androgenic substances. Steroidogenic and trophic effects of corticotropin are mediated by activation of adenylate cyclase and increased production of cAMP. Corticotropin also stimulates growth of adrenal cortex and may possess extra-adrenal effects (i.e. melanocyte stimulation, tissue lipase activation). Primary physiologic and pharmacologic effects are secondary to secretion of cortisol. In pharmacologic doses, cortisol decreases inflammation and suppresses the immune response by a variety of mechanisms. The role of corticotropin decreasing infantile spasms may be explained by reducing CRH release.
Therapeutic use
Infantile spasms. Diagnostic aid in adrenocortical insufficiency. Acute exacerbations of multiple sclerosis. Severe muscle weakness in myasthenia gravis.
Pregnancy and lactiation implications
Safe use of corticotropin during pregnancy not established. Fetal abnormalities (e.g. cleft palate) reported following administration of glucocorticoids to pregnant women. If corticotropin must be used during pregnancy or if the patient becomes pregnant while taking the drug, the potential risks should be carefully considered. Excretion in breast milk unknown (use caution).
Unlabeled use
Contraindications
Hypersensitivity to corticotropin or any component of the formulation. Scleroderma. Osteoporosis. Systemic fungal infections. Ocular herpes simplex. Peptic ulcer.
Warnings and precautions
May mask signs of infection (do not administer live vaccines). Long-term therapy in children may retard bone growth. Acute adrenal insufficiency may occur with abrupt withdrawal after chronic use or with stress. Use with caution in hypothyroidism, cirrhosis, thromboembolic disorders, seizure disorders, or renal insufficiency. Corticotropin may decrease ^131^I uptake.