ACTH 1-39

ACTH 1-39, the full-length, naturally occurring sequence of adrenocorticotropic hormone, is used therapeutically as a repository (depot) corticotropin injection for a range of conditions including infantile spasms (West syndrome), acute multiple sclerosis exacerbations, and certain other inflammatory or nephrotic conditions in some countries. It works upstream of corticosteroid drugs by stimulating the patient's own adrenal glands to produce cortisol, rather than supplying a synthetic corticosteroid directly. Diagnostic testing of adrenal function most often uses a shorter synthetic ACTH fragment (ACTH 1-24, cosyntropin), so ACTH 1-39 products are used predominantly for their therapeutic rather than diagnostic role. It is a prescription-only biologic requiring endocrinology or neurology supervision due to the risk of adrenal suppression and Cushingoid effects with repeated courses. Reported benefits include stimulates the body's own cortisol production for conditions responsive to increased glucocorticoid activity, first-line option for infantile spasms in many treatment guidelines, used for acute exacerbations of multiple sclerosis as an alternative to high-dose corticosteroids.

Reported ranges run 20-80 IU. A low protocol is 20 IU every 24-72 hours, indication-dependent, and a high protocol is 80 IU every 24-72 hours, indication-dependent (higher-intensity regimens). This is reference information, not a dosing recommendation.

Plasma half-life of roughly 15 to 30 minutes, but the repository gel formulation prolongs absorption and biological effect over approximately 24 hours. That is what sets the dosing frequency, and it is why the timing guidance is as directed by your clinician.

Intramuscular: into muscle. Administered by intramuscular or deep subcutaneous injection as a repository (depot) gel formulation; diagnostic adrenal stimulation testing more commonly uses synthetic ACTH(1-24).

Short, defined courses per indication, such as 2 to 3 weeks for an MS exacerbation or several weeks with tapering for infantile spasms on, followed by Tapered off gradually rather than stopped abruptly; not used continuously long-term due to adrenal suppression risk off. Repeated or prolonged courses raise the risk of adrenal suppression and Cushingoid side effects and require close endocrinology or neurology monitoring.

Reported side effects include adrenal suppression and risk of adrenal insufficiency after stopping, cushingoid effects (weight gain, hypertension, fluid retention) with repeated or prolonged courses, increased infection risk due to immunosuppression, irritability and sleep disturbance, particularly in infants treated for spasms, hyperglycemia. Evidence level for this compound is well studied.