Dosage and Administration
Standard tests for verification of adrenal responsiveness to corticotropin may utilize as much as 80 units as a single injection or one or more injections of a lesser dosage. Verification tests should be performed prior to treatment with corticotropins. The test should utilize the route(s) of administration proposed for treatment. Following verification, dosage should be individualized according to the disease under treatment and the general medical condition of each patient. Frequency and dose of the drug should be determined by considering severity of the disease, plasma and urine corticosteroid levels and the initial response of the patient. Only gradual change in dosage schedules should be attempted, after full drug effects have become apparent.
The chronic administration of more than 40 units daily may be associated with uncontrollable adverse effects.
When reduction in dosage is indicated this should be done gradually by either reducing the amount of each injection, administering injections at longer intervals or by a combination of both of the above. During reduction of dosage careful consideration should be given to the disease being treated, the general medical conditions of the patient and the duration over which corticotropin was administered.
The usual dose of H.P. Acthar® Gel (Repository Corticotropin Injection) is 40-80 units given intramuscularly or subcutaneously every 24-72 hours.
In the treatment of acute exacerbations of multiple sclerosis daily intramuscular doses of 80-120 units for 2-3 weeks may be administered.
Preparation: H.P. Acthar Gel (Repository Corticotropin Injection) should be warmed to room temperature before using.
Caution: Do not over pressurize the vial prior to withdrawing the product.