Trade Names:Cortrosyn- Injection, lyophilized powder for reconstitution 0.25 mg
Trade Names:Cosyntropin- Injection, solution 0.25 mg/mL
Exhibits full corticosteroidogenic activity of natural corticotropin, stimulating the adrenal cortex to produce and secrete adrenocortical hormones.
Diagnostic testing of adrenal function.
IM/IV (direct injection) 0.25 to 0.75 mg. IV infusion 0.25 mg in dextrose 5% in water or saline 0.9% administered at 0.04 mg/h over 6 h.Note
Cortrosyn may be administered IM or IV; cosyntropin must be administered by IV only.Children 2 yr of age and younger
IM/IV 0.125 mg often will be sufficient.
Store at 59° to 86°F.Cosyntropin
Store refrigerated at 36° to 46°F; protect from light and freezing.
May antagonize anticholinesterase effects in myasthenia gravis.Barbiturates
May decrease pharmacologic effect of cosyntropin.Carbamazepine
May decrease pharmacological effect of cosyntropin.Diuretics
Corticotropin may accentuate the electrolyte loss associated with diuretic therapy.Hydantoins
May increase clearance and decrease therapeutic efficacy of cosyntropin.Interleukin-2
Pharmacologic effects may be decreased by cosyntropin; avoid coadministration.Mifepristone
Coadministration is contraindicated.Ritodrine
Potential for increased risk of maternal pulmonary edema when coadministered with cosyntropin.Warfarin
May require reduced dosage of warfarin; monitor INR closely and adjust dose as needed.
None well documented.
Rare hypersensitivity (eg, slight whealing with splotchy erythema at injection site).
MonitorPlasma cortisol concentrations
Measure plasma cortisol concentrations prior to and 30 min after administration. Collect blood sample of 6 to 7 mL in heparinized tube.Urinary steroids
Alternatively, measure urinary steroids before and after IV infusion.
Category C .
Exhibits slight immunologic activity but is less likely to cause reactions than natural ACTH.
Patients taking cortisone or hydrocortisone on the test day and patients taking spironolactone may exhibit abnormally high basal plasma cortisol levels. A decrease in plasma cortisol values following a stimulating dose of cosyntropin in patients taking cortisone or hydrocortisone may be seen, while a normal response is expected in patients taking spironolactone.
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