Generic Name: corticotropin, Parenteral Gel

H.P. Acthar

All Brands

  • H.P. Acthar
SECTION 1 of 4

Highlights for corticotropin

Parenteral Gel
1

Corticotropin is most often used to treat multiple sclerosis in adults and infantile spasm (a form of seizure). It may also be used to treat inflammatory or immune-related conditions involving joints, muscles, kidneys, and eyes.

2

The dose of corticotropin injection is different for each medical condition it treats. Your dose and how often you take it will depend on how severe your condition is and other factors.

3

Don’t stop taking corticotropin suddenly unless your doctor tells you to. Stopping suddenly can cause adrenal gland problems.

4

Common side effects may include water retention, increased blood pressure, higher blood sugar levels, and behavior or mood changes. These are more likely if you take this drug for a long time.

IMPORTANT INFORMATION

Infection warning

Corticotropin lowers your immunity and reduces your body’s ability to fight infections. You may get new infections more easily or experience more severe symptoms if you get an infection. When you’re taking corticotropin avoid people who are sick or have symptoms of infection. People who have had inactive tuberculosis may experience the condition again after taking corticotropin for a long time. They may need antibiotics to prevent tuberculosis symptoms from returning. Tell your doctor if you or family members have symptoms of an infection, such as:

  • fever
  • cough
  • vomiting
  • diarrhea
  • signs of illness or flu

Don't stop suddenly

Your doctor will tell you when and how to stop the injections. When stopping injections, tell your doctor if you:

  • feel weak
  • lose your appetite or weight
  • are tired or have no energy
  • have pale skin, stomach pain, or fever

Adrenal insufficiency

Taking this drug can decrease your body's normal ability to produce the hormone cortisol. If you stop taking this drug, you may not be able to produce enough cortisol. If you have a medical procedure such as surgery during this time, you may need a steroid drug to help your body produce enough of the hormone.

Drug Features

Corticotropin is a prescription drug. It is available as a self-injectable solution.

Why It's Used

Corticotropin, also called ACTH or adrenocorticotropic hormone, is used to treat numerous conditions.

More Details

How It Works

Corticotropin causes your body to produce a substance called cortisol, which affects your immune system and helps to decrease inflammation.

More Details

Why It's Used

Corticotropin, also called ACTH or adrenocorticotropic hormone, is used to treat numerous conditions. These include:

  • multiple sclerosis: used as an alternative to steroid medicines that treat worsening multiple sclerosis flare-ups
  • infantile spasm, a form of seizures in children up to 2 years old
  • nervous system and muscular disorders that can affect your skin, eyes, joints, lungs, and other areas of your body
  • serum sickness
  • swelling due to kidney disease

How It Works

Corticotropin causes your body to produce a substance called cortisol, which affects your immune system and helps to decrease inflammation.

Multiple sclerosis is the result of an overactive immune system that causes inflammation and damage to the protective covering around your nerves. This leads to the symptoms you experience. Corticotropin stimulates the release of the hormone cortisol. This decreases immune function and inflammation, resulting in decreased symptoms.

It’s not known exactly how corticotropin works to treat infantile spasm.

SECTION 2 of 4

corticotropin Side Effects

Parenteral Gel

Most Common Side Effects

The most common side effects that occur with corticotropin include:

  • too much salt and water in your body (water retention)

  • increased blood pressure

  • low potassium levels

  • higher blood sugar levels

  • behavior or mood changes

  • increased appetite, especially when the dose or length of therapy increases

  • weight gain

  • irritability

  • problems sleeping

  • diarrhea

  • infections

  • fever

  • acne

  • rash

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1. 

  • infection. Symptoms may include:

    • fever
    • cough
    • vomiting
    • diarrhea
    • signs of illness or flu
  • pain in your stomach or abdomen, vomiting blood, or having red or black stool

  • slowed growth and physical development in children—possible in long-term use

  • Cushing syndrome—also possible with long-term use. Symptoms may include:

    • increased fat around your neck but not on your arms and legs
    • weight gain
    • thinned skin
    • easily bruised skin
    • stretch marks
  • other effects of long-term use, including:

    • decreased bone formation
    • weak bones
    • enlarged heart
    • cataracts
    • increased pressure in the eyes (glaucoma)
    • eye infections

    Side effects that occur with long-term use should go away after you stop taking the drug. 

  • adrenal insufficiency. Symptoms may include:

    • feeling weak
    • loss of appetite
    • weight loss
    • feeling tired or having no energy
    • pale skin
    • stomach pain
    • fever
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Corticotropin does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

corticotropin May Interact with Other Medications

Parenteral Gel

Corticotropin may interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Water pills (diuretics)

Combining corticotropin with water pills increases your risk of low potassium levels. Water pills (diuretics) used to treat high blood pressure or heart conditions may cause potassium to be excreted in your urine. Corticotropin may also cause more potassium and calcium to be excreted.

Live vaccines

This drug suppresses your immune system. You should avoid live or live attenuated vaccines while taking this drug. These vaccines could cause you to experience the conditions they’re intended to prevent. Talk to your doctor before you get a flu shot or any other vaccine.

Some live or live attenuated vaccines include:

  • measles, mumps, and rubella vaccine
  • chickenpox vaccine
  • nasal spray flu vaccine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with diabetes

Corticotropin can worsen your control of your blood sugar level.

People with myasthenia gravis

Corticotropin is sometimes used to treat myasthenia gravis. However, most people experience temporary worsening of myasthenia gravis symptoms after initial treatment, such as muscle weakness.

People with underactive thyroid (hypothyroidism)

Corticotropin can have a stronger effect and might be more likely to cause side effects if you have low thyroid levels.

People with cirrhosis

Corticotropin can have a stronger effect and might be more likely to cause side effects if you have cirrhosis.

People with other conditions

You may be unable to use corticotropin if you have these conditions. Tell your doctor if you have:

  • infections from birth (congenital infections)
  • skin hardening (scleroderma)
  • weak bones (osteoporosis)
  • fungal infections in your blood
  • an infection with herpes simplex in the eye
  • recent surgery
  • past or current stomach ulcer (peptic ulcer)
  • congestive heart failure
  • uncontrolled high blood pressure
  • adrenal gland that produces too much or too little hormone (adrenocortical hyperfunction or insufficiency)
  • allergic reactions to pork products

Pregnant women

Corticotropin is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects, including death of the fetus, when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Corticotropin should only be used during pregnancy if the benefit is greater than the potential risk.

Women who are nursing

It isn’t known if corticotropin passes through human milk. If it does, it could cause serious side effects in a breastfeeding baby.

Talk to your doctor if you take this drug and want to breastfeed.

For Children

Corticotropin injections can be done on your own with a syringe and needle. Keep needles away from children and dispose of them properly after you use them.

Don’t put needles into trashcans or recycling bins or flush them down the toilet. Ask your pharmacist for a needle clipper and container for disposing used needles and syringes. Your community may have program for disposing needles and syringes.

When to call the doctor

Call your doctor if you:

  • have an infection or get a fever. It’s possible to have a fever without infection when taking corticotropin.
  • have had contact with someone who has an infection, especially chicken pox, measles, tuberculosis, or herpes
  • If you’re stopping corticotropin therapy, call your doctor if you:
    • need surgery
    • experience a trauma
    You may need other medicine to protect you from the stress of surgery or trauma.
  • If your child is taking this medication for infantile spasm, call your doctor if your child has a new seizure.

Allergies

Corticotropin is produced from pigs. Don’t use corticotropin if you have an allergy to pork products.

It’s possible to have an allergic reaction after you’ve injected corticotropin several times. Tell your doctor if you have signs of an allergic reaction, such as: 

  • skin rash
  • swelling of your face, tongue, lips, or throat
  • trouble breathing 

Adults have also experienced dizziness, nausea, and shock during allergic reaction.

SECTION 4 of 4

How to Take corticotropin (Dosage)

Parenteral Gel

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Multiple sclerosis

Brand: H.P. Acthar Gel

Form: Injectable solution
Adult Dosage (ages 18 years and older)
  • Corticotropin injection is used for 2–3 weeks only when symptoms increase.
  • The dose can be 80–120 units injected every day into your muscle or under your skin.
Child Dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special considerations

Cirrhosis: Corticotropin can have a stronger effect and might be more likely to cause side effects if you have cirrhosis. Your doctor will monitor you closely and adjust your dose if needed.

Infantile spasms

Brand: H.P. Acthar Gel

Form: Injectable solution
Child Dosage (ages 0-1 years)
  • Corticotropin injection is given into the muscle only. The dose is based on body surface area.
  • A dose of 75 units/m2 is given two times per day for two weeks.
  • After two weeks, the dose is gradually decreased every few days until it can be safely stopped. 
  • It usually takes 2 more weeks to safely stop the drug.  
Special considerations

Cirrhosis: Corticotropin can have a stronger effect and might be more likely to cause side effects if you have cirrhosis. Your doctor will monitor you closely and adjust your dose if needed.

Nervous system and muscular disorders

Brand: H.P. Acthar Gel

Form: Injectable solution
Adult Dosage (ages 18 years and older)

The dose is 40–80 units into the muscle or under the skin every 24–72 hours.

Child Dosage (ages 3-17 years)

The dose is 40–80 units into the muscle or under the skin every 24–72 hours.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special considerations

Cirrhosis: Corticotropin can have a stronger effect and might be more likely to cause side effects if you have cirrhosis. Your doctor will monitor you closely and adjust your dose if needed.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Corticotropin comes with serious risks if you don’t take it as prescribed.

If You Stop Taking It Suddenly

Don’t stop taking corticotropin suddenly unless your doctor has told you to. Stopping the medicine abruptly can change how your adrenal gland produces cortisol (adrenal insufficiency). To decrease your risk, you may need to decrease the dose slowly and increase the time between doses.

If You Miss a Dose

Corticotropin is used to control symptoms. Missing a dose could result in less symptom control and worse symptoms.

How to Tell If the Drug Is Working

For multiple sclerosis, you may be able to tell corticotropin is working of your flare-ups are less severe or don’t last as long.

For infantile spasms, you may be able to tell corticotropin is working if the spasms decrease or stop.

Treatment may be short-term or long-term, depending on what you’re taking it for.

Store in the refrigerator from 36–46°F (2–8°C)

Store this drug away from moisture and areas where it could get wet, such as bathrooms.

Keep corticotropin, the needles, and syringes out of reach of children.

Throw away the vials after the expiration date printed on the label.

Travel

  • This medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to maintain the temperature when traveling.
  • Don’t put corticotropin in your glove compartment or leave it in the car, especially when the temperature is hot or freezing.
  • Needles and syringes need to be used to take this medicine. Check for special rules about traveling with medicine, needles, and syringes when you make travel plans.

Self-Management

Your doctor will tell you where to give the injection, how much to give, how often, and when to give it to your child. Your doctor or nurse will train you how to give the injection to yourself or to your child.

To give yourself a corticotropin injection:

  • Take the bottle from the refrigerator. Don’t open the bottle or pry off the cap (rubber stopper).
  • Warm the contents by rolling the bottle between your hands for a few minutes.
  • Wash your hands.
  • Prepare the skin where you are going to give the injection by wiping it with a new sterile alcohol wipe.
  • Before giving the injection, look at the site prepared for the injection and make sure it’s no longer wet. A wet injection site can cause burning.
  • Wipe the top of the vial rubber stopper with a new sterile alcohol wipe.
  • Use a new needle and syringe to draw up to the amount of corticotropin injection the doctor told you to use.
  • Give the injection the way the doctor showed you, either into the muscle (IM injection) or under the skin (subcutaneous injection).
  • Return the bottle to the refrigerator as soon as possible.

For the corticotropin injection, you’ll need:

  • sterile alcohol wipes
  • a syringe
  • a needle
  • a needle clipper
  • a container for safe disposal of needles and syringes

Clinical Monitoring

While you’re taking corticotropin, your doctor may check your:

  • blood pressure
  • blood sugar levels
  • potassium, sodium, and calcium
  • appetite and weight
  • heart function
  • if you have an infection or stomach problems
  • stool color
  • mood
  • sleep 

If you’re taking corticotropin long-term, your doctor may check:

  • growth (in children)
  • bone density
  • pressure in your eyes and exams for cataracts or infections
  • skin color changes (pigmentation)

Your Diet

Your doctor may watch for increased salt and water in your body (water retention) and check your potassium and salt blood levels.

The doctor will tell you if you need to decrease table salt or if you need to eat foods high in potassium.

Hidden Costs

Besides the medicine, you’ll need to purchase sterile alcohol wipes, syringes, and needles. You may also need a needle clipper and container for safe disposal of needles and syringes.

Insurance

Many insurance companies require prior authorization to make sure corticotropin is used correctly and safely. Your doctor and pharmacist may provide your insurance company information they need for your insurance claim.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on March 31, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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