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Cosyntropin

    DEA Class; Rx

    Common Brand Names; Cortrosyn, Synthetic ACTH

    • Diagnostics, Endocrine

    Parenteral synthetic peptide of corticotropin (ACTH)
    Used for diagnostic testing of adrenal function
    Less potent and less allergenic than other exogenous ACTH preparations

    Indicated for adrenocortical insufficiency diagnosis.

    Hypersensitivity to cosyntropin, synthetic ACTH, or to any excipients

    Flushing

    Mild fever

    Pruritus

    Chronic pancreatitis

    Hypersensitivity

    Rash

    Peripheral edema

    Tachycardia

    Bradycardia

    Adrenal hemorrhage

    Anaphylactic reaction

    Use caution in patients with gastrointestinal disease, cardiovascular disease, hepatic disease, infections, myasthenia gravis, ocular disease, psychiatric disturbances, osteoporosis, renal disease, thyroid disease

    Reactions including anaphylaxis are possible; monitor patients for hypersensitivity reactions and treat as needed

    Accuracy of diagnosis can be complicated by concomitant medications taken by patient; any condition that elevates or lowers cortisol binding globulin levels may increase or decrease plasma total cortisol levels, respectively

    Pregnancy

    Safety in pregnant women not established; there are no adequate and well controlled studies of cosyntropin in pregnant women; therapy should be used during pregnancy only if potential benefit justifies potential risk to fetus

    Lactation

    Not known whether cosyntropin is excreted into human milk; because many drugs are excreted in human milk and because of potential for serious adverse reactions in nursing infants from cosyntropin, caution should be exercised when treatment is administered to a nursing woman

    Adults

    Usual maximum dose is 0.25 mg/test IV or IM. NOTE: 0.75 mg IV has been used in studies; however, maximal response is seen with 0.25 mg dose.

    Geriatric

    Usual maximum dose is 0.25 mg/test IV or IM. NOTE: 0.75 mg IV has been used in studies; however, maximal response is seen with 0.25 mg dose.

    Adolescents

    0.25 mg/test IV or IM.

    Children

    Children > 2 years: 0.25 mg/dose IV or IM
    Children <= 2 years: 0.125 mg/dose IV or IM.

    Infants

    0.125 mg IV or IM.

    Neonates

    0.015 mg/kg/dose IV or IM in term neonates. A variety of dosage regimens are used, up to 3.5 mcg/kg/dose IV in premature neonates. Optimal dosage not definitive for premature neonates.

    Cosyntropin

    powder for injection

    • 0.25mg/vial