Corticotropin (Injection)

Corticotrophin is administered by injection to treat multiple sclerosis and other disorders in adults and infantile spasms in babies and children.

Overview

Corticotropin is an injection that is used to treat a range of conditions in both adults and babies. In babies and infants up to the age of two, the treatment is used for the treatment of infantile spasms. In adults, it is commonly used for the treatment of multiple sclerosis. This treatment can also be used by adults in treating disorders of the joints, autoimmune diseases, skin conditions, eye conditions, lung conditions, allergies and swellings.

Corticotropin is a hormone-releasing treatment that promotes the release of corticosteroids from the adrenal gland of patients. It triggers the same response in the body that is normally triggered by stress and in doing so provides the body with the chemicals it needs to reduce the symptoms of multiple sclerosis and infantile spasms, in addition to other conditions.

This medication is only available when prescribed by a doctor and is administered as HP Acthar. The medication is injected into the patient and takes the form of a gel or jelly.

A nurse usually administers this medication in a hospital or clinic. In some cases, however, the patient may be taught to administer the treatment at home. Before doing so you should ensure that you are completely confident in knowing what you are doing to safely administer the correct dose. If you have any questions then you should consult your doctor.

Conditions treated

  • style="font-weight: 400;">Multiple sclerosis
  • Infantile spasms
  • Joints, disorders of the
  • Autoimmune diseases
  • Skin, conditions of the
  • Eyes, conditions of the
  • Lungs, conditions of the
  • Allergies, certain kinds of
  • Swelling of the body, certain kinds of

Type of medicine

  • Adrenocorticotropic hormone (ACTH)

Side effects

In addition to the required effects from the use of Corticotropin by injection, the use of this medication can also cause unwanted side effects in you or in your baby. While not all of these side effects may occur, if they do then you may need to seek medical attention. Some side effects may occur only in infants, while others may occur only in adults.

If you experience any of the following side effects then you should contact your doctor immediately:

Occurring more commonly:

  • Backache
  • Blurring of vision
  • Body ache
  • Body pain
  • Bone fractures
  • Changed heartbeat
  • Changes to or loss of voice
  • 400;">Chest pains
  • Congestion of the ear
  • Congestion of the nasal passage
  • Coughing
  • Decrease or loss of sexual ability
  • Decrease or loss of sexual desire
  • Difficulty in breathing
  • 400;">Dizziness
  • Earache
  • 400;">Feverishness or chills
  • Fullness or rounding of face, neck or trunk
  • Growth of facial hair in females
  • 400;">Headaches
  • Increased thirstiness
  • Increased volume or frequency of urination
  • Irritability or quickness to annoyance
  • Menstrual changes
  • Muscle wasting
  • Pounding in the ears
  • Runny nose
  • Shortness of breath
  • Sneezing
  • Soreness of the throat
  • Swelling inside the ear
  • Tightness in the chest
  • Troubled breathing
  • Unusual nervousness
  • Unusual tiredness
  • Unusual weakness
  • Wheezing
  • White patches on mouth, throat or tongue
  • White patches with rash in diaper area

Occurring less commonly:

  • Convulsions or seizures

Frequency of occurrence unknown:

  • Accumulation of pus
  • Area of infection around injection site
  • Bloated feeling
  • Bulging of eyeballs out of eye sockets
  • Bulging of the spot part of the skull (infant only)
  • Changed ability to perceive colours, especially yellow or blue
  • Cold or clammy skin
  • Confusion or disorientation
  • Decrease in range of motion
  • Decrease in urine output
  • Dilated veins in the neck
  • Extreme fatigue
  • Fast but weak pulse
  • Full feeling
  • 400;">Heartburn
  • 400;">Insomnia
  • Irregularity of breath
  • Irregularity of heartbeat
  • Joint pains
  • Lightheadedness
  • Limping
  • Loss of hunger
  • Nausea
  • Patches on the skin that may be blue or purple
  • Pressure within the stomach
  • Red and/or purple spots appearing on the skin
  • Severe headaches
  • Sweating when cool
  • Swollen abdomen and/or stomach
  • Swollen face and/or extremities
  • Trouble with wounds healing
  • Unexplained or easy bruising
  • Vomiting
  • Weight gain
  • Wheezing

Frequency of occurrence in adults not known:

  • Bloating
  • Chills
  • Confusion or disorientation
  • 400;">Constipation
  • Coughing up of blood
  • Darker colouration of urine
  • Feverishness
  • Headaches
  • Increased heartbeat
  • Increased sweating when cool
  • 400;">Indigestion
  • Loss of hunger
  • Pain in the stomach, side, abdomen and possibly the back
  • Pain of the muscles
  • Red appearance of the face
  • 400;">Skin rash
  • Sudden and severe headaches
  • Unexplained weight loss
  • Unusual weakness
  • Yellowing of the eyes
  • Yellowing of the skin

Frequency of occurrence in infants not known:

  • Decreased ability to tolerate carbohydrates
  • Hypokalemic alkalosis
  • Reversible shrinkage of the brain

Other side effects can occur that would not usually require that you seek the attention of a doctor. If the following side effects become bothersome or are ongoing, however, then you can consult a healthcare professional for advice on how to alleviate them:

Occurring more commonly:

  • Blemishing appearing on the skin
  • 400;">Diarrhea
  • Pimples or spots

Occurring less commonly:

  • Increased appetite
  • Decreased appetite

Frequency of occurrence not known:

  • Increased growth of hair, particularly on the face
  • Menstrual changes
  • Muscle weakness

Frequency of occurrence in adults not known:

  • Feeling that oneself or surroundings are constantly moving
  • Sensation of spinning
  • Thinning of the skin

Other side effects that have not been listed herein may also occur. If other side effects occur, then you should inform your doctor and seek advice on what to do. If your health is immediately at risk from side effects, however, then you should call the emergency services and seek urgent medical attention. Ensure that you inform them of the treatment you have taken.

Dosage

This medication must be administered by a nurse or trained medical professional in a hospital or clinic environment. It will be injected as a shot under the skin or directly into one of your muscles.

In some cases, this medication may be prescribed to be given at home. If you are administering this dose to your child at home then you should be shown how to administer the correct dose properly. Do not administer this dose unless you are completely confident that you know what you are doing.

For the treatment of infants for infantile spasms, this medication will usually be prescribed with a medication guide. Before use, you should read this thoroughly and ensure that you understand it. If there is anything that you do not understand then you should consult your doctor before any use of the treatment.

This shot should be injected into a different body part each time it is used to prevent the development of skin conditions. Your doctor will show you the locations where the treatment may be injected and you should rotate between these injection sites to allow the skin time to heal between doses. This is more important with infants who will be more susceptible to skin conditions developing.

To use this medication adhere to the following instructions:

  • Remove the vial from refrigeration
  • Allow the treatment to warm to room temperature
  • Wash your hands thoroughly
  • Do not pressurize the vial before removing the medication.
  • Sterilize the injection area with an alcohol wipe and allow to dry
  • Sterilize the rubber stopper on the vial
  • Use a new needle to withdraw the prescribed amount of medication
  • Administer the dose as your doctor showed you.
  • Return the vial to the refrigerator.

The dose of this medication given to each patient will vary dramatically depending on the condition being treated, the age of the patient and the body size of the patient. You should take the dose prescribed to you and should not take more of the medication than prescribed, nor use it more frequently. The following dosing information is a guideline only and you should follow the instructions of your doctor at all times:

For the treatment of infantile spasms:

Children aged 2+ - Use must be determined by the doctor.
Children aged under 2: Dose given will be based on body size and will be calculated by your doctor. The dose will be administered twice daily for a period of two weeks.

For the treatment of multiple sclerosis

Adults: Usual dose will be 80-120 units daily for 2-3 weeks. Your doctor may adjust the dose.
Children: Use and dose must be determined by the doctor.

For the treatment of other conditions:

Adults: Usual dose will be 40-80 units every 24-72 hours. Your doctor may adjust the dose.
Children: Use and dose must be determined by the doctor.

This medication requires use on a fixed schedule. You should ensure that doses are given at the correct times. If you miss a dose then you should contact your doctor.

Interactions

Some medications should not be used together under any circumstances. In other cases, however, medications that may interact with one another can still be used as long as the doses are adjusted. When you are taking any medication you should inform your doctor of all medications you are taking and all treatments you are undergoing as they may impact your use of the medication. For Corticotropin, it is especially important that you inform your doctor of the use of any of the following before you begin treatment:

This medication should not be used in conjunction with the following medication:

Use of Corticotropin with the following treatment would not usually be recommended. If both treatments are prescribed together then your doctor may make changes to the dose of medications or to the frequency of use of one or both of the treatments.

  • Bupropion

The use of Corticotropin in conjunction with the following may increase the risk of the side effects from one or both of the medications. You may still be prescribed both treatments, but your doctor may change the dose or frequency of use of one or more of the treatments:

  • Tosufloxacin
  • Sparfloxacin
  • Saiboku-To
  • Rufloxacin
  • Prulifloxacin
  • Pefloxacin
  • Pazufloxacin
  • Ofloxacin
  • Norfloxacin
  • Nadifloxacin
  • Moxifloxacin
  • Lomefloxacin
  • Licorice
  • Levofloxacin
  • Gemifloxacin
  • Gatifloxacin
  • Flumequine
  • Fleroxacin
  • Enoxacin
  • Ciprofloxacin
  • Besifloxacin
  • Balofloxacin

Other interactions with Corticotropin may exist. This list has been selected for severity and likelihood of occurrence only. You should inform your doctor of all medications that you are taking before you begin treatment.

Other medical conditions from which you suffer can also affect the use of this treatment. You should inform your doctor if you have any other medical conditions and this is especially important if you suffer from the following:

Do not use in patients who suffer from:

  • Adrenal problems
  • History of allergy to pork proteins
  • Congenital infections
  • Congestive heart failure
  • Fungus infections
  • 400;">Herpes simplex of the eye
  • Uncontrolled Hypertension
  • 400;">Osteoporosis
  • History or Peptic ulcer
  • 400;">Scleroderma
  • Recent Surgery
  • Infection
  • Lennox-Gastaut syndrome

The following conditions may be worsened by the use of corticotropin:

  • 400;">Cataracts
  • 400;">Cirrhosis
  • Cushing's syndrome
  • History of depression
  • Diabetes
  • 400;">Edema
  • Emotional problems
  • Eye infections
  • com/health/coma/">400;">Glaucoma
  • Hypertension
  • Hypokalemia
  • 400;">Hypothyroidism
  • Severe kidney disease
  • Mental illness
  • 400;">Myasthenia gravis
  • Stomach problems
  • Latent Tuberculosis

Other medical conditions not listed herein may also impact the use of this treatment. You should inform your doctor of your full medical history before beginning use.

Warnings

In deciding to take Corticotropin you should consider the risks of use in relation to the good that it will do for you. This is a decision to be made by you and your doctor having considered all of the following:

Allergies: You should inform your doctor of all allergies that you have suffered from. For the use of Corticotropin, it is particularly important to share any allergies you have suffered to pork proteins in the past. Such allergies may prohibit the use of this treatment. You should also inform the doctor of any other allergies from which you suffer including dyes, preservatives and other substances.

Pediatric: This medication is suitable for use in the treatment of infantile spasms. Use for the treatment of other medical conditions in children would not usually be recommended, however. Children over the age of two should not usually be treated with this medication for infantile spasms.

Geriatric: No information relating to the use of this treatment and the limitations of such in the elderly is available at the moment. Beware of age-related medical conditions that may limit safe or efficient use.

Pregnancy: Corticotropin has been linked with spontaneous preterm birth in pregnant women. This hormone will be released into maternal and fetal circulation and as such presents a risk to the unborn baby. If you are pregnant then you should inform your doctor of this before you begin use of the treatment and discuss the risks of doing so with them. During treatment, you should use contraception to prevent yourself from becoming pregnant. If you believe that you have become pregnant during use then you should inform your doctor right away.

Breastfeeding: There is no adequate information to determine the risk of breastfeeding whilst using this treatment. You should discuss the risks in relation the benefits of doing so with your doctor before use.

You should keep regular appointments with your doctor during use to ensure that the medication is working properly and no unwanted side effects are occurring. Blood tests may be taken to determine this.

No live vaccines should be received during treatment with Corticotropin. There is a risk that you will contract the disease that you are trying to vaccinate against.

This medication can increase your risk of developing infections. You should avoid people with infections and consider wearing a face protector when you are in contact. Check in with your doctor straight away if you believe you are developing an infection of any kind including a cough, cold or any other illness.

Prolonged use of this medication or use of this medication in excessive doses can lead to the development of problems with your adrenal gland. Symptoms of this are as follows and should be immediately reported to your doctor:

  • Blurring of vision
  • Dizziness
  • Fainting
  • Irregularity of heartbeat
  • Bone fracturing
  • Increased thirst
  • Increased frequency or volume of urination
  • Rounding of face
  • Weight changes
  • Unusual tiredness
  • Unusual weakness

This medication can cause fluid retention. If this occurs then you will need to follow advice on a special diet to reduce the occurrence of this.

Bowel problems can occur during the use of this drug. Report the following symptoms of bowel problems to your doctor immediately:

  • Indigestion
  • Heartburn
  • Vomiting of coffee-ground material
  • Diarrhea
  • Constipation
  • Black stools
  • Bloody stools

This medication can cause mood changes in patients. Report any unusual changes of mood to your doctor immediately.

You may need to get your eyes checked by a doctor during use of this medication. This is particularly important if you experience any of the following changes to your eyes:

  • Redness
  • Itching
  • Swelling
  • Vision perception

Osteoporosis can develop from the use of this treatment. This can lead to low bone growth and exposure to injury at any age. Discuss this with your doctor to determine the level of risk from use.

This medication should not be stopped suddenly. Your doctor may need to reduce your dose slowly to avoid any unwanted effects from occurring. You should always visit a doctor before making any changes to the use of this treatment.

Storage

This medication should be stored in the fridge. Do not allow to freeze. Keep medication out of the reach of children at all times.

Ask your healthcare professional how to dispose of unwanted or outdated medication safely.

Used needles should be put into a hard container that the needles cannot poke through before disposal. This container should be kept away from both pets and children and should be safely disposed of.

Summary

Corticotropin is used for the treatment of a wide range of conditions. Most commonly it is used in the treatment of multiple sclerosis in adults and infantile spasms in children.

The treatment is prescribed as HP Acthar and is administered as an injection. In most cases, this is given by a nurse in a hospital or clinic, but in some cases, the patient may be taught to administer it to themselves or their child at home. In this case, you should be completely certain that you understand how to use this treatment safely and in the correct dose before administering it. If you have any questions about this you should clarify them with your doctor before use.

Use of Corticotropin will expose the patient to risks from a number of side effects and can in rare cases lead to the development of serious medical conditions including bowel problems, osteoporosis and eye problems. It is important that the patient understands all of these risks before use and learns to identify the signs that such conditions might be developing so that they can be treated.

Once this treatment has been started, it is important that it is not stopped abruptly as this can negatively impact the condition that is being treated by the medication. This medication must be taken on a schedule and you should endeavour not to miss any scheduled appointments or doses of this treatment.

The use of this medication when pregnant can be harmful to the unborn baby. You should discuss pregnancy with your doctor before use and take steps to prevent pregnancy from occurring whilst you are using this treatment.

This medication interacts with a wide range of other treatments and you should ensure that your doctor is fully aware of all other treatments that you are taking before using this treatment. Once this treatment has begun, be sure to inform any other medical professionals with whom you interact that you are taking this treatment.

Resources
Last Reviewed:
February 01, 2018
Last Updated:
April 14, 2018