Corticotropin (ACTH Gel)
Also known as: Acthar Gel, Purified Cortrophin Gel, Repository corticotropin, ACTH
Long-acting ACTH gel (Acthar, Cortrophin), FDA-approved for infantile spasms (Acthar only), MS relapses and other conditions. Prescription only.
Last updated
Mechanism of Action
Corticotropin is the 39-amino-acid pituitary hormone ACTH, supplied as a long-acting gel derived from porcine pituitary. It binds the melanocortin-2 receptor in the adrenal cortex, stimulating cortisol and other corticosteroid secretion, which produces anti-inflammatory and immunosuppressive effects. It also binds other melanocortin receptors (MC1R, MC3R-MC5R); whether this adds benefit beyond the steroid response is debated. The gel formulation slows absorption to prolong its action.
- Half-life
- ACTH ~15 minutes in plasma; the gel prolongs absorption over hours
- Administration Routes
- Intramuscular, Subcutaneous
- Research Status
- Clinical
Reported Benefits
- Monotherapy for infantile spasms in children under 2 (Acthar only)
- Acute exacerbations of multiple sclerosis in adults
- Labeled for selected rheumatic, nephrotic, ophthalmic and other corticosteroid-responsive conditions
Potential Side Effects
- Corticosteroid-like effects: fluid retention, hypertension, hyperglycemia, mood changes
- Increased infection risk and masking of infection
- Weight gain and Cushingoid features with prolonged use
- Adrenal suppression on withdrawal
- In infants: irritability, hypertension, infections
Common Dosing
Given by intramuscular or subcutaneous injection; labeled regimens differ by indication (for infantile spasms, a body-surface-area dose given intramuscularly for two weeks followed by a taper). It is not given intravenously. Dosing is set and supervised by the prescribing clinician.
The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.
Contraindications
- Intravenous administration
- Scleroderma, osteoporosis, systemic fungal infection, ocular herpes simplex, recent surgery, peptic ulcer
- Congestive heart failure, uncontrolled hypertension, primary adrenal insufficiency or hyperfunction
- Sensitivity to porcine proteins; live vaccines during immunosuppressive doses
No documented stacking partners for Corticotropin (ACTH Gel) yet.
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High-dose corticotropin (ACTH) versus prednisone for infantile spasms: a prospective, randomized, blinded study
1996
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Results from a multicenter, randomized, double-blind, placebo-controlled study of repository corticotropin injection for multiple sclerosis relapse that did not adequately respond to corticosteroids
2022
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Characterization of the Clinical Evidence Supporting Repository Corticotropin Injection for FDA-Approved Indications: A Scoping Review
2022