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Corticotropin Dosage

Applies to the following strength(s): 40 units ; 25 units ; 40 units/mL ; 80 units/mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Multiple Sclerosis

Acute exacerbations of Multiple Sclerosis: 80 to 120 units daily intramuscularly or subcutaneously for 2 to 3 weeks.

Usual Adult Dose for Ankylosing Spondylitis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Polymyositis/Dermatomyositis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Rheumatoid Arthritis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Sarcoidosis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Systemic Lupus Erythematosus

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Uveitis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Iritis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Optic Neuritis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Keratitis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Juvenile Rheumatoid Arthritis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Psoriatic Arthritis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Iridocyclitis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Chorioretinitis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Choroiditis

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Stevens-Johnson Syndrome

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Serum Sickness

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Adult Dose for Erythema Multiforme

Other indications for Adults and Children over 2 years of age: 40-80 units given intramuscularly or subcutaneously every 24 to 72 hours.

Usual Pediatric Dose for West Syndrome

Infantile spasms for children under 2 years of age: 75 units/m2 twice daily intramuscular administered over a 2 week period, then gradually tapered over a 2 week period to avoid adrenal insufficiency.

Renal Dose Adjustments

Data not available.

Liver Dose Adjustments

Data not available.

Dose Adjustments

Corticotropin should be gradually tapered over a 2 week period to avoid adrenal insufficiency. One suggested tapering schedule: 30 units/m2 in the morning for 3 days; 15 units/m2 in the morning for 3 days; 10 units/m2 in the morning for 3 days; and 10 units/m2 every other morning for 6 days.

Precautions

Corticotropin is contraindicated for intravenous administration.

Corticotropin is contraindicated in infants with congenital infections.

Live or live attenuated vaccines are contraindicated in patients receiving corticotropin.

Corticotropin is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history or presence of peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency, adrenocortical hyperfunction, or sensitivity to proteins of porcine origin.

Corticotropin can increase the risks related to infection. Patients with latent tuberculosis or tuberculin reactivity should be closely monitored.

Monitor for signs and symptoms of hypothalamic-pituitary-axis (HPA) and Cushing's syndrome.

After stopping corticotropin, monitor for signs of adrenal insufficiency. Since these symptoms can be difficult to identify in infants, parents and caregivers should be instructed to monitor for and recognize them. Tapering the dose of corticotropin when discontinuing treatment can minimize adrenal insufficiency.

Corticotropin can increase blood pressure, salt and water retention, and the excretion of potassium and calcium. Monitor patients with hypertension, congestive heart failure, or renal insufficiency.

Monitor patients during and for a period following corticotropin therapy for signs of infection, abnormal cardiac function, hypertension, hyperglycemia, change in body weight and fecal blood loss.

Prolonged corticotropin therapy can have negative effects on growth and physical development in children that should be monitored.

Bone density should be monitored during long term therapy.

Sudden discontinuation of corticotropin can lead to adrenal insufficiency or recurrent symptoms, therefore consider tapering the dose and increasing the injection interval to gradually discontinue.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available.

Other Comments

Refrigerate corticotropin between 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius).

Corticotropin should be warmed to room temperature prior to use.

The manufacturer's product information should be consulted for complete reconstitution and dilution recommendations.

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