cosyntropin (Cortrosyn)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

GENERIC NAME: cosyntropin

BRAND NAMES: Cortrosyn

DRUG CLASS AND MECHANISM: Cosyntropin is a manufactured version of the body's natural adrenocorticotropin hormone (ACTH). ACTH is produced by the pituitary gland in the brain. It stimulates the adrenal gland to release steroids including hydrocortisone and cortisone, androgens, as well as aldosterone. Cosyntropin has the same activity as ACTH. The FDA approved Cosyntropin in April 1970.



PREPARATIONS: Powder (with and without preservatives) 0.25 mg; Solution: 0.25 mg/mL in 1 mL vial

STORAGE: Cosyntropin powder should be stored at room temperature between 15 C to 30 C (59 F to 86 F). Cosyntropin solution and suspension should be stored under refrigeration between 2 C to 8 C (36 F to 46 F) and protected from light and freezing. Infusions are stable for 12 hours at room temperature.

PRESCRIBED FOR: Cosyntropin is used in diagnostic tests to distinguish the presence of primary (adrenal dysfunction) versus secondary (pituitary dysfunction) adrenocortical insufficiency. The intramuscular injection may be used for other disease processes including collagen, dermatologic, endocrine, ocular, and hemolytic disorders.

DOSING: The initial dose for adults is based on what the drug is being used for and whether it is being given intravenously or intramuscularly. For example, the intravenous dose in diagnosing adrenocortical insufficiency is 0.25 mg. Initial doses of 1 mg intramuscularly may be used when transferring from corticosteroids.

DRUG INTERACTIONS: Cosyntropin may increase the electrolyte loss during diuretic therapy.

PREGNANCY: Cosyntropin is a Category C drug. There are no adequate studies of cosyntropin in pregnant women.

NURSING MOTHERS: It is unknown whether cosyntropin is excreted in breast milk and, therefore, should be used cautiously by mothers who are nursing.

SIDE EFFECTS: Adverse effects associated with the use of cosyntropin include slowed heart rate, high blood pressure, edema (fluid buildup) in limbs, and rapid heartbeat. Other adverse effects include rash as well as redness at the injection site. Side effects associated with corticosteroid use are also commonly reported with cosyntropin use. There have been rare reports of anaphylactic reactions.

REFERENCE: FDA Prescribing Information.

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