Cosyntropin
Mechanism :
Stimulates the adrenal cortex to secrete adrenal steroids (including hydrocortisone, cortisone), androgenic substances, and a small amount of aldosterone
Indication :
- Screening of adrenocortical insufficiency:
- Adrenal vein sampling (AVS) in primary aldosteronism
- Therapeutic use: Synacthen Depot
Contraindications :
Hypersensitivity to cosyntropin or any component of the formulation, Treatment of asthma or other allergic conditions (increased risk of anaphylactic reactions); use in premature babies and neonates <1 month; acute psychosis; untreated bacterial, fungal, and viral infections; active or latent peptic ulcer; refractory heart failure; Cushing syndrome; treatment of primary adrenocortical insufficiency; adrenogenital syndrome.
Dosing :
Screening of adrenocortical insufficiency:
IM, IV
≤2 years of age: 0.125 mg.
>2 years of age: 0.25 mg.
Therapeutic use:
Synacthen Depot:
3 to 6 years:
Initial: 0.25 to 0.5 mg daily; maintenance: 0.25 to 0.5 mg every 2 to 8 days
7 to 15 years:
Initial: 0.25 to 1 mg daily; maintenance: 0.25 to 1 mg every 2 to 8 days
≥16 years of age:
Initial for acute treatment: 1 mg daily for 3 days; maintenance dose is individualized: 0.5 to 1 mg every 2 to 3 days or twice weekly or 2 mg once weekly or less frequently.
Adverse Effect :
Bradycardia, hypertension, peripheral edema, tachycardia, Skin rash, urticaria at injection site, Anaphylaxis, hypersensitivity reaction, Adrenal hemorrhage (Synacthen Depot).
Interaction :
Clonazepam, Diazepam, Nitrazepam: Cosyntropin may enhance the hepatotoxic effect.
Phenobarbital, Phenytoin, Primidone, Valproate: Cosyntropin may enhance the hepatotoxic effect.
Hepatic Dose :
No dosage adjustments are recommended.