Acthar is indicated for the treatment of acute exacerbations of multiple sclerosis in adults.

Controlled clinical trials have shown Acthar to be effective in speeding the resolution of acute exacerbations of multiple sclerosis. However, there is no evidence that it affects the ultimate outcome or natural history of the disease.

Multiple Sclerosis Relapses

Dosing and Administration

Acthar is a highly purified sterile preparation of the adrenocorticotropic hormone in 16% gelatin to provide a prolonged release after subcutaneous (SC) or intramuscular (IM) injection.

Recommended dose

The recommended dose is daily subcutaneous or intramuscular doses of 80-120 units for 2-3 weeks for acute relapses.1

Dosing considerations

  • Dosage should be individualized according to the general medical condition of each patient
  • Frequency and dose of the drug should be determined by considering the severity of the disease and the initial response of the patient
  • Side effects are similar to those seen with corticosteroids. Common side effects include fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite, and weight gain1

Please see Important Safety Information below. For a full list of indications, contraindications, warnings, precautions, and adverse events related to Acthar, please refer to the full Prescribing Information.

SC Injection
Training Video

Step-by-step instructions on how to inject Acthar subcutaneously.

SC Injection Training Video2:45

IM Injection
Training Video

Step-by-step instructions on how to inject Acthar intramuscularly.

IM Injection Training Video2:43

Dosing and administration support from Questcor

As part of our commitment to patients with MS relapses, Questcor provides a variety of home injection training and treatment support services:

  • Self-administration educational materials, including downloadable instructions and online videos for you to use with your staff and for patient training (visit the Resource Library)
  • Acthar Patient Site offers self-injection instructions to help patients learn on their own time
  • The Acthar Information Kit is a collection of tools to help your patients better understand MS relapse symptoms and treatment with Acthar. These materials are available through an Acthar Specialty Sales Consultant

References

Acthar is indicated for the treatment of acute exacerbations of multiple sclerosis in adults.

Controlled clinical trials have shown Acthar to be effective in speeding the resolution of acute exacerbations of multiple sclerosis. However, there is no evidence that it affects the ultimate outcome or natural history of the disease.

Reference:

  1. H.P. Acthar Gel Prescribing Information. Hayward, CA: Questcor Pharmaceuticals Inc.

Important Safety Information

Acthar should never be given intravenously. It is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history of or the presence of a peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction, or sensitivity to proteins of porcine origin. Acthar is contraindicated in children under 2 years of age with suspected congenital infections. Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of Acthar.

The adverse effects that may occur with Acthar are related primarily to its steroidogenic effects and are similar to corticosteroids. There may be increased susceptibility to new infection and increased risk of reactivation of latent infections. Adrenal insufficiency may occur after abrupt withdrawal of the drug following prolonged therapy. Cushing's syndrome, elevated blood pressure, salt and water retention, and hypokalemia may be seen. Masking of symptoms of other underlying disease/disorders may occur. There is a risk of gastrointestinal perforation and bleeding with increased risk of perforation in patients with certain GI disorders. Onset or worsening of euphoria, insomnia, irritability (especially in infants), mood swings, personality changes, depression, and psychosis may occur. Caution should be used when prescribing Acthar to patients with diabetes or myasthenia gravis. Prolonged use may produce cataracts, ocular infections, or glaucoma. Use in patients with hypothyroidism or liver cirrhosis may result in an enhanced effect. There may be negative effects on growth and physical development and decreases in bone density.

Specific adverse reactions reported in IS clinical trials in infants and children under 2 years of age included infection, hypertension, irritability, Cushingoid symptoms, constipation, diarrhea, vomiting, pyrexia, weight gain, increased appetite, decreased appetite, nasal congestion, acne, rash, and cardiac hypertrophy. Convulsions were also reported, but these may actually be occurring because some IS patients progress to other forms of seizures and IS sometimes masks other seizures, which become visible once the clinical spasms from IS resolve.

Other adverse reactions in adults and children over 2 years of age included abdominal distension, anxiety, asthma, chest discomfort, congestive heart failure, dizziness, dyspnea, erythema, fatigue, flushing, headache, hyperhidrosis, hypersensitivity or allergic reactions, injection site pain, muscle weakness, palpitations, peripheral edema, tachycardia, and weakness.

This is a summary only. For a full list of indications, contraindications, warnings, precautions, and adverse events related to Acthar, please refer to the full Prescribing Information.

Indications for Use

H.P. Acthar® Gel (repository corticotropin injection) is an adrenocorticotropic hormone (ACTH) analogue used for:

  • Monotherapy treatment of infantile spasms in infants and children under 2 years of age.
  • The treatment of acute exacerbations of multiple sclerosis in adults.
  • Inducing a diuresis or a remission of proteinuria in the nephrotic syndrome without uremia of the idiopathic type or that due to lupus erythematosus.
  • The treatment of an exacerbation or as maintenance therapy in selected cases of dermatomyositis (polymyositis).
  • The following: rheumatic disorders; collagen diseases; dermatologic diseases; allergic states; ophthalmic diseases; and respiratory diseases.

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Important Safety Information

Acthar should never be given intravenously. It is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history of or the presence of a peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency or adrenocortical hyperfunction, or sensitivity to proteins of porcine origin. Acthar is contraindicated in children under 2 years of age with suspected congenital infections. Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of Acthar.

The adverse effects that may occur with Acthar are related primarily to its steroidogenic effects and are similar to corticosteroids. There may be increased susceptibility to new infection and increased risk of reactivation of latent infections. Adrenal insufficiency may occur after abrupt withdrawal of the drug following prolonged therapy. Cushing's syndrome, elevated blood pressure, salt and water retention, and hypokalemia may be seen. Masking of symptoms of other underlying disease/disorders may occur. There is a risk of gastrointestinal perforation and bleeding with increased risk of perforation in patients with certain GI disorders. Onset or worsening of euphoria, insomnia, irritability (especially in infants), mood swings, personality changes, depression, and psychosis may occur. Caution should be used when prescribing Acthar to patients with diabetes or myasthenia gravis. Prolonged use may produce cataracts, ocular infections, or glaucoma. Use in patients with hypothyroidism or liver cirrhosis may result in an enhanced effect. There may be negative effects on growth and physical development and decreases in bone density.

Specific adverse reactions reported in IS clinical trials in infants and children under 2 years of age included infection, hypertension, irritability, Cushingoid symptoms, constipation, diarrhea, vomiting, pyrexia, weight gain, increased appetite, decreased appetite, nasal congestion, acne, rash, and cardiac hypertrophy. Convulsions were also reported, but these may actually be occurring because some IS patients progress to other forms of seizures and IS sometimes masks other seizures, which become visible once the clinical spasms from IS resolve.

Other adverse reactions in adults and children over 2 years of age included abdominal distension, anxiety, asthma, chest discomfort, congestive heart failure, dizziness, dyspnea, erythema, fatigue, flushing, headache, hyperhidrosis, hypersensitivity or allergic reactions, injection site pain, muscle weakness, palpitations, peripheral edema, tachycardia, and weakness.

This is a summary only. For a full list of indications, contraindications, warnings, precautions, and adverse events related to Acthar, please refer to the full Prescribing Information.

Indications for Use

H.P. Acthar® Gel (repository corticotropin injection) is an adrenocorticotropic hormone (ACTH) analogue used for:

  • Monotherapy treatment of infantile spasms in infants and children under 2 years of age.
  • The treatment of acute exacerbations of multiple sclerosis in adults.
  • Inducing a diuresis or a remission of proteinuria in the nephrotic syndrome without uremia of the idiopathic type or that due to lupus erythematosus.
  • The treatment of an exacerbation or as maintenance therapy in selected cases of dermatomyositis (polymyositis).
  • The following: rheumatic disorders; collagen diseases; dermatologic diseases; allergic states; ophthalmic diseases; and respiratory diseases.