Cortrophin Gel
Purified Cortrophin Gel is used to treat many different types of inflammatory conditions in adults and children. It can help with conditions like rheumatoid arthritis, lupus, and psoriasis, among others. Cortrophin Gel (corticotropin) comes in a vial and contains adrenocorticotropic hormone (ACTH) with other similar proteins. The medication is typically taken every day. You have to draw up each dose into a syringe from the vial. Then, the medication gets injected either under the skin or into the muscle. Side effects include skin thinning and acne.
What is Cortrophin Gel (corticotropin)?
What is Cortrophin Gel (corticotropin) used for?
- Flare-ups of arthritis (e.g., psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, gouty arthritis)
- Systemic lupus erythematosus (SLE), also known as lupus
- Systemic dermatomyositis (a muscle condition)
- Stevens-Johnson syndrome
- Severe psoriasis
- Eczema
- Serum sickness (a type of allergic reaction)
- Eye inflammation
- Sarcoidosis (a lung condition)
- Fluid buildup from kidney damage due to lupus or an unknown cause
- Flare-ups of multiple sclerosis
How Cortrophin Gel (corticotropin) works
Cortrophin Gel (corticotropin) is a mix of adrenocorticotropic hormone (ACTH) analogs and similar proteins. This mixture works like the natural ACTH that your body makes.
Cortrophin Gel (corticotropin) helps the adrenal gland release steroid hormones like cortisol into the body. These steroid hormones help reduce inflammation. They also lower the activity of the immune system. This can help treat some autoimmune and inflammatory conditions.
Drug facts
| Common Brands | Cortrophin Gel |
|---|---|
| Drug Class | Adrenocorticotropin stimulating hormone |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Cortrophin Gel (corticotropin)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- See "Other Side Effects" and "Risks and Warnings"
Less Common Side Effects
- Reaction where you injected the medication (e.g., irritation, pain, redness)
- Swelling due to fluid buildup
- Bloating
- Muscle weakness
- Headache
- Skin thinning
- Darkening of skin color
- Acne
- More sweating
- Longer healing time for wounds
- Weight gain
- High blood sugar
- High blood pressure
Cortrophin Gel (corticotropin) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infection: fever, difficulty breathing, headache, weakness, confusion, sweating, chills, stiff neck, muscle aches, diarrhea, fast heart rate
- Stomach problem: burning stomach pain, burning feeling in the chest, acid reflux, bloody or dark stools, coughing or vomiting up blood or coffee-ground bits
- Eye problem: eye pain, blurry vision, other vision changes
- Severe allergic reaction: hives; rash; dizziness; nausea; vomiting; swelling of the lips, tongue, or face; difficulty breathing; chest pain
The following Cortrophin Gel (corticotropin) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Backache
blurred vision
body aches or pain
chest pain or tightness
chills
difficulty with breathing
dizziness
ear congestion
facial hair growth in females
fractures
full or round face, neck, or trunk
headache
increased thirst or urination
irritability
loss of sexual desire or ability
loss of voice
menstrual irregularities
muscle wasting
nervousness
pounding in the ears
redness or swelling in the ear
runny or stuffy nose
seizures
slow or fast heartbeat
unusual tiredness or weakness
white patches in the mouth or throat or on the tongue
white patches with diaper rash
Incidence not known
Accumulation of pus
bruising
bulging soft spot on the head of an infant
change in the ability to see colors, especially blue or yellow
decreased range of motion
decreased urine output
dilated neck veins
extreme tiredness or weakness
eyeballs bulge out of the eye sockets
fast, weak pulse
full or bloated feeling
irregular breathing
irregular heartbeat
joint pain
large, flat, blue, or purplish patches in the skin
lightheadedness
limp
loss of appetite
noisy, rattling breathing
pressure in the stomach
severe headache
slow healing
small red or purple spots on the skin
swelling of the stomach area
swelling of the face, fingers, feet, or lower legs
swollen, red, or tender area of infection
trouble sleeping
vomiting
Incidence not known-For adults only
cold clammy skin
confusion
coughing up blood
dark urine
feeling of constant movement of self or surroundings
headache, sudden and severe
increased sweating
indigestion
loss of appetite
pain in the muscles
pains in the stomach, side, or abdomen, possibly radiating to the back
redness of the face
sensation of spinning
skin rash
sweating
thinning of the skin
unusual weight loss
weakness
yellow eyes or skin
Incidence not known-For infants only
excess air or gas in the stomach or bowels
mood changes
muscle pain or cramps
numbness or tingling in the hands, feet, or lips
passing gas
problems with speech or speaking
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Changes in appetite
Incidence not known
Bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
general feeling of discomfort or illness
increased hair growth, especially on the face
muscle weakness
unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Cortrophin Gel (corticotropin)
Pros
- Can help treat a lot of different inflammatory conditions
- Can inject the medication at home after you get trained
Cons
- Must draw up dose into a syringe; doesn't come prefilled
- Can cause withdrawal symptoms if you stop taking the medication too suddenly
Pharmacist tips for Cortrophin Gel (corticotropin)
- Cortrophin Gel (corticotropin) can raise your risk of a serious infection. Call your primary care provider if you have signs of an infection, like fever, weakness, sweating, chills, cough, difficulty breathing, or diarrhea, while you're taking this medication. You might have to stop taking Cortrophin Gel (corticotropin) so your body can fight the infection as best as it can.
- Before getting any vaccines, tell the healthcare professional that you're taking Cortrophin Gel (corticotropin). Ask your care team if you're not sure whether you can get the vaccine you want. You might need to avoid certain vaccines, like the smallpox vaccine or other live vaccines. It's not known how Cortrophin Gel (corticotropin) affects your body's response to vaccines.
- Don't lower your dose or stop taking Cortrophin Gel (corticotropin) suddenly without talking to your prescriber first. Otherwise, you might have withdrawal symptoms like weakness, body aches, and stomach pain. Work with your care team to see how to safely lower your dose or stop the medication.
- Make sure your care team knows about all your medical conditions. Some health conditions, like thyroid problems and liver cirrhosis) can cause Cortrophin Gel (corticotropin) to have a stronger effect. Other conditions, like diabetes, myasthenia gravis, and kidney problems, can get worse during treatment.
How to use Cortrophin Gel (corticotropin):
- Keep the vials of Cortrophin Gel (corticotropin) in the refrigerator. For the 1 mL vials, they're good for 6 months after you first use the vial. For the 5 mL vials, they're good for 28 days after you first use the vial. If the expiration date on the vial is sooner than these time frames, throw away the vials on the expiration date.
- Your healthcare team will give you training on how to draw up your dose into a syringe and inject Cortrophin Gel (corticotropin). Your prescriber will tell you what needle sizes to use to draw up the dose and inject the medication. Ask your care team if you have any questions on how to prepare and inject the medication.
- Before you draw up your dose, roll the Cortrophin Gel (corticotropin) vial between your hands for a few minutes to warm the medication up. The medication turns into a solid gel in the refrigerator. But it should become liquid after it's warmed up. Don't microwave or use the stove to warm up the medication.
- For injections under the skin: Inject Cortrophin Gel (corticotropin) into the fatty part under the skin either on top of your thigh or your stomach (at least 1 inch from the belly button). You can also ask someone to inject the medication into the fatty part under the skin on the side or at the back of your upper arm. Pinch the skin, insert the needle at a 45º angle, and push down on the plunger to inject the medication.
- For injections into a muscle: Inject Cortrophin Gel (corticotropin) into the muscle of your upper-outer thigh. Someone can also help inject the medication into the muscle of your upper arm. Hold the skin where you're going to inject. Then, insert the needle at a 90º angle and push down on the plunger to inject the medication. Never inject into a vein.
- Choose a different spot each time you inject Cortrophin Gel (corticotropin) to prevent skin irritation. Make sure there's at least an inch between the areas where you inject the medication. Use the injection calendar to write down where you injected the medication each time.
- Once you're done with your injection, put the Cortrophin Gel (corticotropin) vial back into the refrigerator. Throw away the used needle and syringe in a sharps container or heavy-duty plastic container, like an empty laundry detergent bottle. This helps lower the risk of needle-stick injuries. Don't throw them away in your trash can. Visit the FDA's website for information about throwing away your sharps container safely.
Risks and warnings for Cortrophin Gel (corticotropin)
Cortrophin Gel (corticotropin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infections
Cortrophin Gel (corticotropin) can make it harder for your body to fight infections. This raises your risk of serious bacterial, viral, or fungal infections. If you had tuberculosis (TB) in the past, it could come back while you're taking this medication. Your prescriber might recommend antibiotics or antivirals during treatment to help prevent infection.
Call your primary care provider or go to urgent care right away if you have signs of an infection, like fever, chills, and tiredness. Keep in mind that Cortrophin Gel (corticotropin) might hide some signs of infection. If you get sick, you might need to stop taking Cortrophin Gel (corticotropin) until you get better so your body can fight the infection.
Changes in adrenal gland function
- Risk factors: Taking Cortrophin Gel (corticotropin) for a long period of time | Stress (such as trauma, injury, or infection)
Cortrophin Gel (corticotropin) acts like the adrenocorticotropic hormone (ACTH) that your body naturally makes. When you take Cortrophin Gel (corticotropin) long term, your body releases more of a stress hormone called cortisol. This raises your risk of having symptoms of Cushing's syndrome (when you have too much cortisol in your body). Symptoms include swelling, weight gain, face roundness, and muscle weakness. Tell your care team if you notice these symptoms while you're taking Cortrophin Gel (corticotropin).
Cortrophin Gel (corticotropin) can also affect how much natural ACTH that your body releases. When you lower your dose or stop taking the medication suddenly after long-term use, your body can't make its own ACTH fast enough. This is especially true in physically stressful situations (e.g., injury, infection). It can lead to withdrawal symptoms, like low energy, tiredness, body aches, and stomach upset. Tell your care team if you want to take a lower dose or stop the medication. Your prescriber will slowly lower your dose over time.
Risk of stomach ulcers or stomach bleeding
- Risk factors: Stomach ulcers or bleeding | Taking other medications that can cause stomach damage at the same time | Drinking alcohol
Cortrophin Gel (corticotropin) can raise the risk of stomach damage, stomach ulcers and possibly stomach bleeding. Talk to your prescriber about your risk for stomach problems and what you can do to lessen this risk. Tell your care team if you have burning stomach pain that doesn't go away, a burning feeling in the chest, or acid reflux. These can be signs of a stomach ulcer. And get medical care right away if you have signs of stomach bleeding, like bloody or dark stools.
High blood pressure, swelling, and electrolyte problems
- Risk factors: Heart failure | High blood pressure | Kidney problems
Cortrophin Gel (corticotropin) can cause your body to hold onto more salt and water. This can lead to higher blood pressure and swelling. The medication can also cause your electrolyte levels to change, such as lower potassium levels and lower calcium levels. Talk to your prescriber if you have heart failure, high blood pressure, or kidney problems. These side effects can lead to complications for you.
Weakened bones
- Risk factors: Taking Cortrophin Gel (corticotropin) for a long period of time
Taking Cortrophin Gel (corticotropin) over a long period of time can lead to weakened bones and osteoporosis. This can raise the risk of breaking a bone (fracture), especially in older adults. Get medical help or go to urgent care if you think you broke a bone.
Slowed growth in children
- Risk factors: Taking Cortrophin Gel (corticotropin) for a longer period of time | Infants and young children
Cortrophin Gel (corticotropin) can slow growth in children, especially if they need to take the medication for a long time. The care team will check your child's growth during treatment. Talk to the prescriber if you have any concerns about your child's growth and development.
Eye problems
- Risk factors: Cataracts or glaucoma | Using Cortrophin Gel (corticotropin) for a long period of time
Long-term use of Cortrophin Gel (corticotropin) can lead to a higher risk of cataracts, glaucoma, and certain eye infections. Don't take Cortrophin Gel (corticotropin) if you have a viral infection in the eye called herpes simplex because the medication might make it worse. Let your prescriber or optometrist know if you notice eye pain, blurry vision, or any other vision changes.
Changes in mood or behavior
- Risk factors: History of mental health problems
Cortrophin Gel (corticotropin) can cause changes in mood or behavior. They can include feeling extremely happy or depressed. You also might have trouble sleeping, mood swings, or personality changes. It can also make mental health problems worse if you already have them. Tell your prescriber right away if there are any unusual changes in your mood or behavior while you're taking Cortrophin Gel (corticotropin).
Serious allergic reaction
- Risk factors: Allergy to pork-related products | Long-term use
Although rare, people who took Cortrophin Gel (corticotropin) have had serious allergic reactions. Don't take Cortrophin Gel (corticotropin) if you have allergies to pork-related products because this medication contains proteins that come from pigs. Get medical help right away if you notice trouble breathing, swelling of the face or mouth, rash, or hives after you inject this medication. These can be signs of an allergic reaction.
Cortrophin Gel (corticotropin) dosage
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1ml of 80 units/ml | 8 vials | $58,713.45 | $7,339.18 |
Typical dosage for Cortrophin Gel (corticotropin)
In general, your dose depends on what condition you’re using Cortrophin Gel (corticotropin) for and how severe your symptoms are. Your prescriber can adjust the dose based on how well you respond to treatment.
- Flare-up of multiple sclerosis: Your prescriber will determine your dose based on your symptoms. The typical dose ranges from 80 to 120 units per day for 2 to 3 weeks. The medication is injected into the muscle or under the skin.
- Other conditions: Your prescriber will determine your dose based on your symptoms. The medication is injected either into the muscle or under the skin.
After your treatment ends, your prescriber might lower your dose over a few days before you stop taking the medication completely.
Interactions between Cortrophin Gel (corticotropin) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Rotavirus Vaccine, Live
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Balofloxacin
- Besifloxacin
- Bupropion
- Ciprofloxacin
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Levofloxacin
- Lomefloxacin
- Moxifloxacin
- Nadifloxacin
- Norfloxacin
- Ofloxacin
- Pazufloxacin
- Pefloxacin
- Prulifloxacin
- Rufloxacin
- Sparfloxacin
- Tosufloxacin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Licorice
- Saiboku-To
How much does Cortrophin Gel (corticotropin) cost?
$58,713.45
Cortrophin Gel (corticotropin) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Cortrophin Gel (corticotropin) will not be safe for you to take.
- Injecting Cortrophin Gel (corticotropin) into the vein
- Scleroderma (an autoimmune condition that causes skin to harden and become tight)
- Osteoporosis
- Certain fungal infections
- Herpes simplex viral infection in the eyes
- Recent surgery
- Have or have had a stomach ulcer
- Heart failure
- High blood pressure
- Primary adrenocortical insufficiency (your adrenal glands don't make enough of certain hormones)
- Adrenocortical hyperfunction (too many hormones made by the adrenal cortex)
- Allergy to pig (porcine) proteins
What are alternatives to Cortrophin Gel (corticotropin)?
This medication is used for many different conditions. Generally, it's used for autoimmune problems, conditions related to swelling, or cancer. Some examples include:
