Classifications: diagnostic agent; Therapeutic: diagnostic agent
Pregnancy Category: C
0.25 mg injection
Synthetic polypeptide resembling corticotropin (ACTH) in relation to the first 24 of the 39 amino acids in naturally occurring
ACTH. Has less immunologic activity and is associated with less risk of sensitivity than corticotropin.
In patient with normal adrenocortical function, stimulates adrenal cortex to secrete corticosterone, cortisol (hydrocortisone),
several weak androgenic substances, and limited amounts of aldosterone.
Diagnostic tool to differentiate primary adrenal from secondary (pituitary) adrenocortical insufficiency.
In patients with normal adrenocortical function for the long-term treatment of chronic inflammatory or degenerative disorders
responsive to glucocorticoids.
History of allergic disorders; scleroderma, osteoporosis; systemic fungal infections, ocular herpes simplex; recent surgery;
history of or presence of peptic ulcer; CHF; hypertension; adrenocortical insufficiency and adrenocortical hyperfunction;
immunizations, tuberculosis, infections; pregnancy (category C), lactation.
Multiple sclerosis, acute gouty arthritis, mental disturbances, diabetes, abscess, pyrogenic infections, diverticulitis,
renal insufficiency, myasthenia gravis, children.
Route & Dosage
|Rapid Screening Test
Adult/Child (>2 y): IM/IV 0.25 mg
- Reconstitute cosyntropin powder by adding 1.1 mL NS (diluent provided by manufacturer) to vial labeled 0.25 mg to provide
solution containing 0.25 mg/mL.
- Inject deep IM into a large muscle.
- IV administration to neonates, infants and children: Verify correct IV concentration and rate of infusion/injection with
PREPARE: Direct: Reconstitute as for IM. IV Infusion: Further dilute in 250500 mL of D5W or NS.
ADMINISTER: Direct: Give over 2 min. IV Infusion: Give at an approximate rate of 40 mcg/h over 46 h.
- Reconstituted solutions remain stable 24 h at room temperature or 21 d at 2°8° C.
- Cosyntropin should not be added to blood or to plasma infusions.
Adverse Effects (≥1%) Body as a Whole:
Mild fever. GI:
Diagnostic Test Interference
Cortisone, hydrocortisone, estrogen, spironolactone elevated bilirubin, and presence of free Hgb in plasma may interfere with plasma cortisol determinations.
InteractionsDrug: Cortisone, hydrocortisone
can exhibit abnormally high baseline
values of cortisol and a decreased response to cosyntropin test.
cortisol levels double in 1530 min. Peak:
1 h. Duration:
24 h. Distribution:
Unknown; does not cross placenta. Metabolism:
Assessment & Drug Effects
- Normal 17-KS levels in men are 1025 mg/24 h; in women <50 y, 515 mg/24 h; and in women >50 y, 48 mg/24
- Normal 17-OHCS levels in men are 512 mg/24 h; in women, 310 mg/24 h; in children 812 y, <4.5 mg/24 h;
in younger children, 1.5 mg/24 h. Levels may be slightly higher in obese or muscular individuals.