At a glance

Controls infantile spasms (West syndrome)
Speeds MS exacerbation recovery
Anti-inflammatory (steroid-mediated)
Adrenal diagnostic value (cosyntropin)
Adrenal suppression / insufficiency
Infection risk (incl. reactivation)
Blood-pressure / fluid & potassium
Bone loss / GI bleeding (long-term)
Melanocytic lesions / mole changes· class-derived
BenefitSide effectHealth risk· more & brighter bars = stronger

Effects

  • Stimulates cortisol production: Acts on the adrenal cortex to drive synthesis and secretion of glucocorticoids (cortisol), the basis of all its effects.[5][7]
  • Anti-inflammatory / immune-modulating: Via induced cortisol, it suppresses inflammation; used to speed resolution of acute MS exacerbations, though it does not change the disease's ultimate course.[2][3]
  • Controls infantile spasms: Approved as monotherapy for infantile spasms (West syndrome) in infants and children under 2 years.[7]
  • Adrenal diagnostic stimulus: The 1-24 fragment (cosyntropin) acts like natural ACTH to stimulate cortisol, used in the ACTH stimulation test to screen for adrenal insufficiency.[1][4]
Classification

Melanocortin (MC2R) agonist / peptide hormone (corticotropin)

Route

Injectable — IM or subcutaneous (therapeutic); IM/IV (diagnostic). Not for IV use as gel

Structure

39–amino-acid peptide; activity resides in N-terminal 1-24

Onset (diagnostic)

Cortisol rises within ~5 min, roughly doubles by 15–30 min (cosyntropin)

Oral bioavailability

Inactivated by GI proteolytic enzymes — not orally active