Absorption, Distribution and Excretion
Rapidly absorbed following intramuscular administration.
Cosyntropin is rapidly absorbed following IM administration.
Adsorption of tetracosactrin on to zinc phosphate provides for sustained release of the active substance from the intramuscular injection site. After an injection of a mg Synacthen Depot IM, the radioimmunologically determined plasma concentrations of tetracosactrin lie for 12 hours between 200 and 300 pg/mL. Tetracosactrin has an apparent distribution volume of approximately 0.4 L/kg. /Tetracosactrin zinc phosphate complex - depot (NOT available in US)/
The precise distribution and metabolic fate of cosyntropin is not known, but the drug is rapidly removed from the plasma by many tissues. Cosyntropin apparently does not cross the placenta.

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Biological Half-Life
About 15 minutes following intravenous administration.

[1]. Adding Slow Release Tetracosactide Acetate to Eltrombopag Improves Haematological Response in ITP Patients with Platelet-Count Fluctuation. 2018 Nov 29;132(1).

Tetracosactide (also known as Cosyntropin) is a synthetic peptide that is identical to the 24-amino acid segment (sequence: SYSMEHFRWGKPVGKKRRPVKVYP) at the N-terminal of adrenocorticotropic hormone. ACTH (1-24), a segment similar in all species, contains the biological activity that stimulates production of corticosteroids in the adrenal cortex. Tetracosactide exhibits the same activity as natural ACTH with regard to all its biological activities. The complex results in a product whose absorption in man is effected over a longer period of time as compared to corticotropin. Therefore, therapy may be maintained with less frequent administration.
Cosyntropin is a synthetically-derived subunit of the endogenous peptide pituitary hormone adrenocorticotropic hormone (ACTH). Consisting of the first 24 amino acids from the amino terminal of ACTH, Cortrosyn is usually prepared for injection and intended for diagnostic and not therapeutic use. Similar to endogenous ACTH, this agent stimulates the adrenal secretion of specific adrenal steroids that can be measured in the plasma. (NCI04)
A synthetic peptide that is identical to the 24-amino acid segment at the N-terminal of ADRENOCORTICOTROPIC HORMONE. ACTH (1-24), a segment similar in all species, contains the biological activity that stimulates production of CORTICOSTEROIDS in the ADRENAL CORTEX.

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Drug Indication
For use as a diagnostic agent in the screening of patients presumed to have adrenocortical insufficiency.

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Mechanism of Action
Cosyntropin combines with a specific receptor in the adrenal cell plasma membrane and, in patients with normal adrenocortical function, stimulates the initial reaction involved in the synthesis of adrenal steroids (including cortisol, cortisone, weak androgenic substances, and a limited quantity of aldosterone) from cholesterol by increasing the quantity of the substrate within the mitochondria. Cosyntropin does not significantly increase plasma cortisol concentration in patients with primary or secondary adrenocortical insufficiency.
Cosyntropin elicits all the pharmacologic responses usually produced by endogenous corticotropin; however, cosyntropin is immunologically much less active than corticotropin since most of the antigenic activity of corticotropin has been attributed to the C-terminal portion of the molecule (i.e., the 22-39 amino acid residues). In patients with normal adrenocortical function, cosyntropin stimulates the adrenal cortex to secrete cortisol (hydrocortisone), corticosterone, several weakly androgenic substances, and to a very limited extent aldosterone. When cosyntropin is used diagnostically, the effect of the drug is usually measured by determining plasma cortisol concentrations prior to and following administration of the drug. In patients with primary adrenocortical insufficiency (Addison's disease), cosyntropin does not substantially increase plasma cortisol concentrations.

C136H210N40O31S

2933.4370

2931.58

16960-16-0

Tetracosactide acetate;60189-34-6

16133802

White to off-white solid powder

1.5±0.1 g/cm3

1.681

-3.27

42

41

96

208

6500

22

S(C([H])([H])[H])C([H])([H])C([H])([H])[C@@]([H])(C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C(=O)O[H])C(N([H])[C@@]([H])(C([H])([H])C1=C([H])N([H])C([H])=N1)C(N([H])[C@@]([H])(C([H])([H])C1C([H])=C([H])C([H])=C([H])C=1[H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])N([H])/C(=N/[H])/N([H])[H])C(N([H])[C@@]([H])(C([H])([H])C1=C([H])N([H])C2=C([H])C([H])=C([H])C([H])=C12)C(N([H])C([H])([H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])C([H])([H])N([H])[H])C(N1C([H])([H])C([H])([H])C([H])([H])[C@@]1([H])C(N([H])[C@]([H])(C(N([H])C([H])([H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])C([H])([H])N([H])[H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])C([H])([H])N([H])[H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])N([H])/C(=N/[H])/N([H])[H])C(N([H])[C@@]([H])(C([H])([H])C([H])([H])C([H])([H])N([H])/C(=N/[H])/N([H])[H])C(N1C([H])([H])C([H])([H])C([H])([H])[C@@]1([H])C(N([H])[C@]([H])(C(N([H])[C@]([H])(C(N([H])[C@]([H])(C(N([H])[C@@]([H])(C([H])([H])C1C([H])=C([H])C(=C([H])C=1[H])O[H])C(N1C([H])([H])C([H])([H])C([H])([H])[C@@]1([H])C(=O)O[H])=O)=O)C([H])(C([H])([H])[H])C([H])([H])[H])=O)C([H])([H])C([H])([H])C([H])([H])C([H])([H])N([H])[H])=O)C([H])(C([H])([H])[H])C([H])([H])[H])=O)=O)=O)=O)=O)=O)=O)C([H])(C([H])([H])[H])C([H])([H])[H])=O)=O)=O)=O)=O)=O)=O)=O)=O)N([H])C([C@]([H])(C([H])([H])O[H])N([H])C([C@]([H])(C([H])([H])C1C([H])=C([H])C(=C([H])C=1[H])O[H])N([H])C([C@]([H])(C([H])([H])O[H])N([H])[H])=O)=O)=O

ZOEFCCMDUURGSE-SQKVDDBVSA-N

InChI=1S/C136H210N40O31S/c1-75(2)109(127(200)154-71-106(181)156-88(31-13-17-52-137)114(187)158-89(32-14-18-53-138)115(188)159-91(35-21-56-149-134(142)143)116(189)164-96(37-23-58-151-136(146)147)131(204)175-60-25-39-104(175)126(199)173-111(77(5)6)128(201)163-90(33-15-19-54-139)120(193)171-110(76(3)4)129(202)169-101(65-80-43-47-84(180)48-44-80)132(205)176-61-26-40-105(176)133(206)207)172-125(198)103-38-24-59-174(103)130(203)95(34-16-20-55-140)157-107(182)70-153-113(186)99(66-81-68-152-87-30-12-11-29-85(81)87)167-117(190)92(36-22-57-150-135(144)145)160-121(194)98(63-78-27-9-8-10-28-78)166-123(196)100(67-82-69-148-74-155-82)168-118(191)93(49-50-108(183)184)161-119(192)94(51-62-208-7)162-124(197)102(73-178)170-122(195)97(165-112(185)86(141)72-177)64-79-41-45-83(179)46-42-79/h8-12,27-30,41-48,68-69,74-77,86,88-105,109-111,152,177-180H,13-26,31-40,49-67,70-73,137-141H2,1-7H3,(H,148,155)(H,153,186)(H,154,200)(H,156,181)(H,157,182)(H,158,187)(H,159,188)(H,160,194)(H,161,192)(H,162,197)(H,163,201)(H,164,189)(H,165,185)(H,166,196)(H,167,190)(H,168,191)(H,169,202)(H,170,195)(H,171,193)(H,172,198)(H,173,199)(H,183,184)(H,206,207)(H4,142,143,149)(H4,144,145,150)(H4,146,147,151)/t86-,88-,89-,90-,91-,92-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,103-,104-,105-,109-,110-,111-/m0/s1

(2S)-1-[(2S)-2-[[(2S)-2-[[(2S)-6-amino-2-[[(2S)-2-[[(2S)-1-[(2S)-2-[[(2S)-2-[[(2S)-6-amino-2-[[(2S)-6-amino-2-[[2-[[(2S)-2-[[(2S)-1-[(2S)-6-amino-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-amino-3-hydroxypropanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-3-hydroxypropanoyl]amino]-4-methylsulfanylbutanoyl]amino]-4-carboxybutanoyl]amino]-3-(1H-imidazol-4-yl)propanoyl]amino]-3-phenylpropanoyl]amino]-5-carbamimidamidopentanoyl]amino]-3-(1H-indol-3-yl)propanoyl]amino]acetyl]amino]hexanoyl]pyrrolidine-2-carbonyl]amino]-3-methylbutanoyl]amino]acetyl]amino]hexanoyl]amino]hexanoyl]amino]-5-carbamimidamidopentanoyl]amino]-5-carbamimidamidopentanoyl]pyrrolidine-2-carbonyl]amino]-3-methylbutanoyl]amino]hexanoyl]amino]-3-methylbutanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]pyrrolidine-2-carboxylic acid

2934.99.9001

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Note: Please store this product in a sealed and protected environment (e.g. under nitrogen), avoid exposure to moisture and light.

Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)

H2O : ~100 mg/mL (~34.09 mM)

Solubility in Formulation 1: 100 mg/mL (34.09 mM) in PBS (add these co-solvents sequentially from left to right, and one by one), clear solution; with sonication.

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 (Please use freshly prepared in vivo formulations for optimal results.)