Formulary
Tetracosactide: Indications, Dosing, Side Effects and Interactions
Tetracosactide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Tetracosactide: Indications, Dosing, Side Effects and Interactions
Tetracosactide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Diagnosis of adrenocortical insufficiency (diagnostic 30-minute test)**
- **Adult** (By Intravenous Injection, Or By Intramuscular Injection): 250 micrograms for 1 dose.
**Diagnosis of adrenocortical insufficiency (diagnostic 5-hour test)**
- **Adult** (By Intramuscular Injection Using Depot Injection): 1 mg for 1 dose.
**Alternative to corticosteroids in conditions such as Crohn's disease or rheumatoid arthritis (formerly used but value was limited by the variable and unpredictable therapeutic response and by the waning of effect with time)**
- **Adult** (By Intramuscular Injection Using Depot Injection): Initially 1 mg daily, alternatively initially 1 mg every 12 hours, (in acute cases), then reduced to 1 mg every 2-3 days, followed by 1 mg once weekly, alternatively 500 micrograms every 2-3 days.
**Diagnosis of adrenocortical insufficiency (diagnostic 30-minute test), standard-dose test for tetracosactide**
- **Child** (By intramuscular injection, or by intravenous injection): 145 micrograms/m2 (max. per dose 250 micrograms) for 1 dose.
**Diagnosis of adrenocortical insufficiency (diagnostic 30-minute test), low-dose test for tetracosactide**
- **Child** (By intramuscular injection, or by intravenous injection): 0.3 microgram/m2 for 1 dose.
**Infantile spasms (under expert supervision) for tetracosactide**
- **Child 1-23 months** (By intramuscular injection using depot injection): 500 micrograms once daily on alternate days for 2 weeks; increased if necessary up to 750 micrograms once daily on alternate days, increased dose to be used if spasms continue or recur after the first 7 days.
Cautions
Active infectious diseases (should not be used unless adequate disease-specific therapy is being given); active systemic diseases (should not be used unless adequate disease-specific therapy is being given); diabetes mellitus; diverticulitis; history of asthma; history of atopic allergy; history of eczema; history of hayfever; history of hypersensitivity; hypertension; latent amoebiasis (may become activated); latent tuberculosis (may become activated); myasthenia gravis; ocular herpes simplex; osteoporosis; predisposition to thromboembolism; pscyhological disturbances may be triggered; recent intestinal anastomosis; reduced immune response (should not be used unless adequate disease-specific therapy is being given); ulcerative colitis Cautions, further information Risk of anaphylaxis Should only be administered under medical supervision-consult product literature. Hypertension Patients already receiving medication for moderate to severe hypertension must have their dosage adjusted if treatment started. Diabetes mellitus Patients already receiving medication for diabetes mellitus must have their dosage adjusted if treatment started.
Contraindications
Acute psychosis; adrenogenital syndrome; allergic disorders; asthma; avoid injections containing benzyl alcohol in neonates; Cushing's syndrome; infectious diseases; peptic ulcer; primary adrenocortical insufficiency; refractory heart failure
Side effects
Frequency not known Abdominal distension; abscess; adrenocortical unresponsiveness; angioedema; appetite increased; bone fractures; congestive heart failure; Cushing's syndrome; diabetes mellitus exacerbated; dizziness; dyspnoea; electrolyte imbalance; exophthalmos; fluid retention; flushing; gastrointestinal disorders; glaucoma; growth retardation; haemorrhage; headache; healing impaired; hirsutism; hyperglycaemia; hyperhidrosis; hypersensitivity (may be more severe in patients susceptible to allergies, especially asthma); hypertension; idiopathic intracranial hypertension exacerbated; increased risk of infection; leucocytosis; malaise; menstruation irregular; muscle weakness; myopathy; nausea; osteonecrosis; osteoporosis; pancreatitis; papilloedema; pituitary unresponsiveness; posterior subcapsular cataract; protein catabolism; psychiatric disorder; seizure; skin reactions; tendon rupture; thromboembolism; vasculitis necrotising; vertigo; vomiting; weight increased
Interactions
**Other interactions (8):**
- Concomitant use of lacidipine and corticoids or tetracosactide might decrease antihypertensive effect.
- Interactions with hypokalaemia inducing drugs: Concomitant use with drugs can induce hypokalaemia such as: diuretics, amphotericin B, tetracosactide (corticotropin analogue), gluco and...
- If not, the radiologist must have resuscitation treatment options.
- Other compounds causing hypokalaemia: amphotericin B (IV), gluco- and mineralo-corticoids (systemic route), tetracosactide, stimulant laxatives Increased risk of hypokalaemia (additive effect).
- Corticosteroids, tetracosactide (systemic route) Decreased antihypertensive effect (water/sodium retention due to corticosteroids).
- Drugs lowering heart rate, causing automaticity or conduction disorders Combined therapy with the following active substances is not recommended: bradycardic active substances such as beta...
Pregnancy
Avoid (but may be used diagnostically if essential).
Breast feeding
Avoid (but may be used diagnostically if essential).
Hepatic impairment
For depot injection , manufacturer advises caution in cirrhosis (may enhance effect of tetracosactide therapy).
Renal impairment
Use with caution in renal failure. M
Medicinal forms
Solution,Injection
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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