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Tetracosactide: Uses, Dosage, and ACTH Stimulation Test Guide
Summary of Key Points
Tetracosactide is a synthetic hormone used to diagnose and treat conditions related to the adrenal glands, such as Addison’s disease and congenital adrenal hyperplasia. It is also beneficial in managing autoimmune disorders like multiple sclerosis, rheumatoid arthritis, and Crohn’s disease. Tetracosactide works by stimulating the adrenal glands to produce cortisol, a hormone that helps regulate inflammation and immune responses. Always consult your healthcare provider before starting or adjusting your dose.
Names of Medication
US Brand Name: Synacthen
Generic Name: Tetracosactide
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name is listed in parentheses.
Pharmacologic Category
Adrenocorticotropic Hormone (ACTH) Analog
Tetracosactide Dosage and Administration
Tetracosactide is prescribed for a variety of conditions, each with specific dosing instructions. Always follow your healthcare provider’s recommendations and never adjust your dose without consulting them. For immediate medical advice, you can schedule a telemedicine appointment with one of our providers.
Tetracosactide Dosage for Addison’s Disease
Dosage: 1 mg intramuscularly (IM) or subcutaneously (SC) once daily for 2-3 weeks.
Tetracosactide Dosage for Congenital Adrenal Hyperplasia
Dosage: 0.25 mg IM or SC every 12 hours for 3-5 days.
Tetracosactide Dosage for Multiple Sclerosis
Dosage: 1 mg IM or SC once daily for 7-14 days.
Tetracosactide Dosage for Rheumatoid Arthritis
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Tetracosactide Dosage for Crohn’s Disease
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Tetracosactide Dosage for Ulcerative Colitis
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Tetracosactide Dosage for Psoriasis
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Tetracosactide Dosage for Asthma
Dosage: 0.25 mg IM or SC every 12 hours for 3-5 days.
Tetracosactide Dosage for Eczema
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Tetracosactide Dosage for Systemic Lupus Erythematosus
Dosage: 1 mg IM or SC once daily for 1-2 weeks, followed by a tapering dose.
Dosage Forms and Strengths of Tetracosactide
Injection: 0.25 mg/mL, 1 mg/mL
Contraindications for Tetracosactide
Contraindications are specific conditions where a medication should not be used due to potential harm. Before starting any new medication, it’s important to understand if you have any conditions that make it unsafe. Below are the contraindications for Tetracosactide:
Allergy to Tetracosactide or ACTH: If you have a known allergy to Tetracosactide or adrenocorticotropic hormone (ACTH), avoid this medication. Allergic reactions can range from mild rashes to severe anaphylaxis, which can be life-threatening.
Peptic Ulcers: Tetracosactide may increase stomach acid production, worsening peptic ulcers and potentially leading to bleeding or perforation.
Severe Hypertension (High Blood Pressure): This medication can cause fluid retention and raise blood pressure, posing risks for those with uncontrolled hypertension.
Congestive Heart Failure: Tetracosactide may cause fluid retention, worsening heart failure symptoms like shortness of breath and swelling.
Infections: If you have a serious infection, especially fungal or viral, Tetracosactide can suppress the immune system, making it harder for your body to fight the infection.
Osteoporosis: Long-term use of Tetracosactide may weaken bones, worsening osteoporosis and increasing fracture risk.
Drug Interactions with Tetracosactide
Tetracosactide can interact with other medications, increasing the risk of side effects or reducing treatment effectiveness. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Tetracosactide:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can increase the risk of stomach ulcers and bleeding when taken with Tetracosactide.
Diuretics: Medications like furosemide (Lasix) or hydrochlorothiazide (Microzide) may increase the risk of low potassium levels when used with Tetracosactide.
Anticoagulants: Blood thinners like warfarin (Coumadin) may have altered effects when taken with Tetracosactide, increasing the risk of bleeding or clotting.
Insulin or Oral Diabetes Medications: Tetracosactide can raise blood sugar levels, potentially requiring adjustments in diabetes medications like metformin (Glucophage) or insulin.
Vaccines: Live vaccines, such as the measles, mumps, and rubella (MMR) vaccine, may be less effective when taken with Tetracosactide, and there may be an increased risk of infection.
Tetracosactide in Pregnancy
Is it safe to take Tetracosactide when pregnant?
The safety of Tetracosactide during pregnancy has not been fully established. While animal studies suggest potential risks, there is limited data available for humans. If you are pregnant or planning to become pregnant, it is important to consult your healthcare provider. They will carefully weigh the benefits and risks before prescribing this medication. If you are already taking Tetracosactide and discover you are pregnant, contact your healthcare provider immediately to discuss your treatment options.
Tetracosactide while Breastfeeding
Is it safe to take Tetracosactide while breastfeeding?
There is limited information on whether Tetracosactide passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is generally recommended to avoid using Tetracosactide while breastfeeding unless absolutely necessary. If you are breastfeeding, consult your healthcare provider to explore the safest treatment options for both you and your baby.
Estimated Cost of Tetracosactide Medication
The cost of a 30-day supply of Tetracosactide can vary depending on the pharmacy and your location. Without insurance, and with the use of a GoodRX coupon, the estimated cost ranges from $1,000 to $1,500 for a 30-day supply. It is advisable to check with your pharmacy for the most accurate pricing and discuss any cost-saving options with your healthcare provider.
Possible Alternatives to Tetracosactide
Depending on your condition, alternative medications or lifestyle changes may help manage your symptoms. Always consult your healthcare provider before making any changes to your treatment plan. If you are interested in exploring alternatives, consider scheduling a telemedicine appointment with one of our providers today.
Addison’s Disease
Alternatives may include hydrocortisone or prednisone, which are corticosteroids that replace the hormones your body is not producing. Additionally, lifestyle changes such as managing stress and maintaining a balanced diet can be beneficial.
Congenital Adrenal Hyperplasia
Treatment alternatives may involve glucocorticoids like dexamethasone or prednisone. Regular monitoring and adjusting doses during periods of stress or illness are also essential for effective management.
Multiple Sclerosis
Alternatives include disease-modifying therapies such as interferon beta (Avonex) or glatiramer acetate (Copaxone). Physical therapy and regular exercise can also play a key role in managing symptoms.
Rheumatoid Arthritis
Alternatives may include methotrexate (Trexall) or biologics like adalimumab (Humira). Incorporating regular exercise and following a healthy diet can also help reduce inflammation and improve overall well-being.
Crohn’s Disease
Alternatives may include biologics such as infliximab (Remicade) or corticosteroids like prednisone. Dietary adjustments, such as avoiding trigger foods, can also help manage symptoms and reduce flare-ups.
Ulcerative Colitis
Alternatives may include mesalamine (Asacol) or biologics like vedolizumab (Entyvio). A low-residue diet may also help minimize flare-ups and improve symptom control.
Psoriasis
Alternatives may include topical treatments like corticosteroids or biologics such as secukinumab (Cosentyx). Regular moisturizing and avoiding known triggers, such as stress, can also help manage symptoms.
Asthma
Alternatives may include inhaled corticosteroids like fluticasone (Flovent) or bronchodilators such as albuterol (ProAir). Avoiding allergens and maintaining a healthy weight can also contribute to better symptom control.
Eczema
Alternatives may include topical corticosteroids or calcineurin inhibitors like tacrolimus (Protopic). Keeping the skin well-moisturized and avoiding irritants can help prevent flare-ups and manage symptoms.
Systemic Lupus Erythematosus
Alternatives may include hydroxychloroquine (Plaquenil) or immunosuppressants like azathioprine (Imuran). Regular exercise and minimizing sun exposure can also help manage symptoms and prevent flare-ups.
Recent Updates on Tetracosactide Research
Recent research on Tetracosactide has focused on its role in diagnosing and managing adrenal insufficiency, particularly in complex cases. Ongoing studies are also exploring its effectiveness in treating autoimmune conditions such as multiple sclerosis and rheumatoid arthritis. Additionally, there is growing interest in its potential use for inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis. However, more clinical trials are needed to confirm these findings and establish long-term safety. If you are interested in learning more about the latest research or participating in a clinical trial, speak with one of our providers during your next telemedicine visit.
