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Generic Name: Repository Corticotropin
Dosage Form: Injectable powder for injection, Injectable solution

H.P. Acthar Gel (repository corticotropin injection) is referred as single therapy for treating infantile spasms in infants and children with less than 2 years of age. It is indicated for treating acute exacerbations of multiple sclerosis in adults too. Restrained clinical attempts have proved gel to be effective in speeding the settlement of intense exacerbations of several scleroses. However, there is no clue that it disturbs ultimate results or natural history of the disease.

The drug also is used in diagnosing adrenal gland function. The drug is used to treat certain conditions which are formed due to allergies; breathing, blood, or endocrine problems; arthritis; skin or eye problems; bowel inflammation; multiple sclerosis; or certain cancers. The drug is also useful in various instances as determined by your doctor. HP Acthar gel is a hormone. It works effectively by appealing body to create more adrenocortical hormones for e.g., corticosteroids, glucocorticoids.

Drug Description:-

H.P. Acthar Gel is a deeply purified sterile arrangement of adrenocorticotropic hormone in 16% gelatin to give a long lasting release followed by intramuscular or subcutaneous injection. It also holds 0.5% phenol, not more than 0.1% cysteine (added), sodium hydroxide and/or acetic acid to adjust pH and water for injection.


The drug is available as 5 mL multi-dose vial containing 80 USP Units per mL.


Infantile spasms – The solution is indicated as monotherapy for the treatment of infantile spasms in infants and children less than 2 years of their age.

Multiple Sclerosis – The formula is used for treating acute exacerbations of multiple sclerosis in adults. Controlled clinical trials have shown the solution to be resultant in speeding the resolution of keen exacerbations of several sclerosis. However, there is no proof that it affects the ultimate outcome or natural history of any disease.


In the treating infantile spasms, it must be administered intramuscularly. The preferred procedure is a daily dose of 150 U/m² (divided into twice daily intramuscular injections of 75 U/m²) intakes over a 2-week of period. The Dosage with should be gradually tapered over a 2-week period to relieve adrenal insufficiently. Further given are some tapering schedule like: 30 U/m² in the morning for 3 days; 15 U/m² in the morning for 3 days; 10 U/m² in the morning for 3 days; and 10 U/m² every other morning for 6-days.

The drug is commonly dosed based on body surface area (BSA). Thus, for calculation of body surface area, use the following formula: BSA (m²) =√ weight (kg) x height (cm) / 3600.

Over Dosage:-

High or over doses can be combined with an array of hidden deliberate conflicting effects. It is unexpected that a single high dose, or even several large doses, has the potential for deliberate adverse effects compared to other standard dose. There have been no records of death or keen overdose symptoms with intake of this drug in clinical studies or in the published informative literature. The intramuscular way of administrating the formula makes it unlikely which a reckless intense overdose may occur. The typical daily dose of the drug to treat an infant suffering from a BSA of 0.4 m² would be 60 U/day. Using the 1-cc syringe supplied with the gel, the maximum amount which is to be injected is 80 U/injection, which is a well-tolerated single dose with no harm and cause.

How to use HP Acthar gel:-

  • The gel is usually administered as an injection you get from your doctor's office, hospital, or clinic. By any chance you are using it at home; carefully follow the injection procedures taught to you by your health care provider or provided under your guide book.
  • Warm HP Acthar gel to room temperature before you bring it in any use.
  • By any chance you miss a dose while you are using 1 dose every other day, use the missed dose the following morning. Or skip 1 day and return to your regular dosing schedule of using a dose every other day.
  • Wipe the top of the vial rubber stopper with a new sterile alcohol wipe before use.
  • Keep this product, as well as syringes and needles away from children and pets.
  • Avoid reusing needles, syringes, or other materials. Dispose the apparatus properly after usage.

Missed Doge:-

If you miss a dose and you are going through 1 dose every other day, intake the missed dose following morning. Then skip 1 day and go back to your regular dosing schedule. If you miss a dose, and you are using 1 or more doses each day, use it as soon as possible by returning to your regular dosing schedule.


H.P. Acthar Gel (repository corticotropin injection) should be stored in warm i.e. in room temperature before using it. Do not over pressurize the vial before using the medicine. Store the solution in refrigerator, between 36° and 46° F (2° and 8° C). Store the formula away from heat, moisture, and light. Do not store in the moisturized places like bathroom. Keep the solution out of the reach of children, infants and pets.

Side Effects:-

Common side effects and reaction which may bothersome people are: Acne; changes in appetite; constipation; diarrhea; difficulty sleeping; headache; heartburn; nausea; restlessness; sweating; vomiting.

Some severe side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in mood; changes in vision; fever or chills; muscle pain or weakness; pain, redness, or swelling at the injection site; seizures; slow wound healing; sore throat.


Your medication needs may revise if you have any unusual stress such as a serious illness, fever or infection, or in case of surgery or any medical emergency. Do not intake any smallpox or "live" vaccine while getting treated under corticotropin. Vaccines may not work as well while getting treated with corticotropin.

Pediatric Use - H.P. Acthar Gel is indicated as monotherapy for the treating infantile spasms in infants and children less than 2 years of age.