Cosyntropin Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Cosyntropin Injection is a man-made form of ACTH used as part of the ACTH stimulation test to help diagnose adrenal gland disorders and screen for adrenocortical insufficiency. It works by stimulating the adrenal glands to produce cortisol, which is then measured to assess adrenal function. It is given as a one-time injection into a vein or muscle by a healthcare provider.

What is Cosyntropin Injection

Cosyntropin is a man-made form of a hormone called adrenocorticotropic hormone (ACTH), which is normally made by the pituitary gland in the brain. It acts like natural ACTH to make the adrenal glands produce cortisol.

Cosyntropin Injection uses

• Used as part of a medical test called an ACTH stimulation test to help diagnose adrenal gland disorders such as Addison's disease, Cushing syndrome, or hypopituitarism
• Used to screen patients who are thought to have adrenocortical insufficiency

Benefits of Cosyntropin Injection

• Gives a rapid way to test adrenal gland function using only two blood draws
• Has very little immune-triggering activity compared with natural ACTH, making it less likely to cause allergic reactions

How Cosyntropin Injection works

Cosyntropin acts like natural ACTH, stimulating the adrenal gland to produce cortisol, which doctors can then measure to see how well the adrenal glands are working.

Cosyntropin Injection dosage

Cosyntropin is given as a one-time injection into a vein or into a muscle by a healthcare provider. Your doctor will measure your cortisol levels before the injection and again later to compare results.

You may be asked to stop taking certain medicines for a period of time before the test, including spironolactone, corticosteroid medicines, or estrogen-containing medicines. If you take spironolactone, you should not take it on the day of the test. If you take a corticosteroid medicine, ask your doctor how long to stop it before the test. If you take estrogen-containing medicine such as hormonal contraceptives or hormone replacement therapy, you should stop taking it several weeks before the scheduled test. Unless your doctor tells you otherwise, continue your normal diet before the test.

Available forms and strengths

• Powder for solution (lyophilized powder for injection)
• Solution for injection

Side effects of Cosyntropin Injection

Common

• Allergic reaction
• Fast or slow heartbeat
• Increased blood pressure
• Rash
• Swelling in hands or feet
• Redness at the injection site
• Lightheadedness

Serious

• Hives, itching, or rash
• Swelling of the face, lips, eyes, tongue, or throat
• Wheezing or trouble breathing
• Weak or rapid pulse with lightheadedness
• Rare anaphylactic (severe allergic) reactions
• Chest pain, discomfort, or tightness
• Difficulty swallowing
• Irregular heartbeat

Warnings and precautions

• Do not receive this medicine if you have ever had an allergic reaction to it.
• This medicine can cause serious allergic reactions, including anaphylaxis, which can be life-threatening and needs immediate medical attention.
• Tell your doctor about all medical conditions, including any electrolyte imbalance such as low potassium or magnesium, and any allergic reaction during a prior ACTH stimulation test.
• It is not known whether cosyntropin can harm an unborn baby. Tell your doctor if you are pregnant.
• It is not known whether cosyntropin passes into breast milk, so it should be used with caution while breastfeeding, weighing the benefits against the risks.
• No routine renal dose adjustment is generally required for a single diagnostic dose. No standard liver-specific dose adjustment is established.
• Discuss with your healthcare professional whether it is safe to use alcohol around the time of this test, since interactions may occur.
• This medicine usually has little direct effect on driving, although dizziness can occasionally occur.

Storage

• Store at controlled room temperature, with brief excursions to a wider temperature range allowed, as listed on the product label
• Cosyntropin powder should be stored at room temperature; the reconstituted solution should not be kept for later use and any unused portion should be discarded

When to see a doctor

• Get emergency medical help right away if you have signs of an allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or swelling of the hands, face, or mouth after receiving this medicine.
• Call your doctor immediately or get emergency treatment if you have hives, itching, rash, swelling of the face, lips, eyes, or throat, wheezing, trouble breathing, a weak or rapid pulse, or lightheadedness.

Alternatives

• Cortrosyn
• Insulin tolerance test
• Metyrapone stimulation test