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Welcome to the Infantile Spasms Dosing Calculator.
This is a convenient and complete way to calculate the recommended dosage of Acthar Gel for the treatment of IS, from per-injection volume to a complete treatment regimen.
The recommended dosage for IS is 150 units/m2 divided into twice daily intramuscular injections of 75 units/m2 over a 2‑week period. Dosing should be gradually tapered and discontinued over a 2‑week period.
Choose initial dose or tapered dose and then enter measurements to determine the corresponding per-injection volume of Acthar Gel for a patient with IS.
INITIAL DOSE
TAPERED DOSE #1
Calculation information
For Infantile Spasms, the Acthar IS Dosing Calculator generates per-injection volume (mL) of Acthar by body surface area (BSA) using the following Mosteller formula calculation22:
To determine per-injection volume of Acthar:
To determine total daily dose:
Input exceeds the FDA-recommended dose
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Input is below the FDA-recommended dose
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Input exceeds the preceding total daily dose
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
The previous dose is outside the FDA-approved recommendation for dose range; therefore, the default taper dose may need assessment
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
Input differs from the FDA-recommended frequency of treatment
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Input differs from the FDA-approved tapering schedule recommendation
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
The symptoms of adrenal insufficiency in infants treated for infantile spasms can be difficult to identify. The symptoms are non-specific and may include anorexia, fatigue, lethargy, weakness, excessive weight loss, hypotension and abdominal pain. It is critical that parents and caregivers be made aware of the possibility of adrenal insufficiency when discontinuing Acthar Gel and should be instructed to observe for, and be able to recognize, these symptoms.
Input exceeds the preceding total daily dose
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
Input exceeds the preceding total daily dose
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
Input exceeds the FDA-recommended total daily dose
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for a total daily dose of 150 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Please note that there are no data to support the use of Acthar at a total daily dose exceeding 150 U/m2. This dosing calculator is not a substitute for clinical judgment. Medical discretion is required to determine any appropriate daily dose and treatment course of Acthar for your IS patients.
Input is below the FDA-recommended total daily dose
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for a total daily dose of 150 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Input differs from the FDA-recommended days on therapy
The FDA approved Acthar for IS with the following recommended dosing regimen1:
- Two daily intramuscular injections of 75 U/m2 for 2 weeks
- After 2 weeks of treatment, Acthar should be gradually tapered over 2 weeks, decreasing the dose to help avoid adrenal insufficiency
Input differs from the FDA-approved tapering schedule recommendation
After 2 weeks of treatment, Acthar should be gradually tapered, decreasing the dose to help avoid adrenal insufficiency. The FDA approved Acthar for IS with the following recommended taper schedule1:
30 U/m2 in the morning for 3 days; 15 U/m2 in the morning for 3 days; 10 U/m2 in the morning for 3 days; and 10 U/m2 every other morning for 6 days.
The symptoms of adrenal insufficiency in infants treated for infantile spasms can be difficult to identify. The symptoms are non-specific and may include anorexia, fatigue, lethargy, weakness, excessive weight loss, hypotension and abdominal pain. It is critical that parents and caregivers be made aware of the possibility of adrenal insufficiency when discontinuing Acthar Gel and should be instructed to observe for, and be able to recognize, these symptoms.
ADD TAPERED DOSE
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USING THE CALCULATOR
Calculation information
For infantile spasms, the Acthar IS Dosing Calculator generates per-injection volume (mL) of Acthar by body surface area (BSA) using the following Mosteller formula calculation22:
To determine per-injection volume of Acthar:
To determine total daily dose:
Calculation information
To determine total volume of Acthar required to complete your selected course of treatment:
To determine number of vials needed:
