If a doctor has ordered a test for adrenal function, cosyntropin may be the agent used to perform it. This synthetic hormone is given to check how well the adrenal glands respond, rather than to treat a disease directly.
Key takeaways
- Cosyntropin is classified as an adrenocorticotropic hormone used as a diagnostic agent.
- It is approved to help screen for adrenocortical insufficiency by prompting a cortisol response.
- The label describes a rapid-acting test that can be completed in about 30 minutes with two venipunctures.
- Cosyntropin (brand name Cosyntropin) carries no boxed warning.
- More than 90 registered trials have studied cosyntropin, largely in the context of adrenal suppression testing.
What Cosyntropin Is
Cosyntropin belongs to the adrenocorticotropic hormone drug class. It is designed to act on the adrenal cortex, prompting it to produce cortisol so clinicians can assess how the adrenal glands are functioning.
What Cosyntropin Is Approved For
Cosyntropin for Injection is approved as a diagnostic agent to screen patients suspected of having adrenocortical insufficiency. Because it acts quickly on the adrenal cortex, it can be used to run a short, roughly 30-minute test of adrenal function that measures plasma cortisol response. The label notes that a low basal cortisol level alone is not enough to confirm insufficiency, since many affected patients have normal baseline levels and show problems only when the body is under stress. This is why the test measures the cortisol response to cosyntropin rather than relying on a single baseline value. The approved product is marketed under the brand name Cosyntropin, and its label does not carry a boxed warning.
What the Evidence Shows
Cosyntropin has been studied in 96 registered trials. Several of these have focused on whether other medications suppress the hypothalamic-pituitary-adrenal axis, using cosyntropin testing as the measurement tool. One completed Phase 2 study compared a topical cream against clobetasol propionate cream for HPA axis suppression in patients with moderate to severe plaque psoriasis. Another completed Phase 2 study evaluated the adrenal suppression potential of a topical product in pediatric patients with atopic dermatitis, again using cosyntropin-based testing as the outcome measure.
Reported Side Effects
Reported cases submitted to a safety surveillance database reflect report counts, not confirmed incidence or causation. The most frequently reported issues involve pregnancy-related exposure findings, including foetal growth restriction (24 reports) and foetal exposure during pregnancy (23 reports). Metabolic and cardiovascular reports follow, including hypoglycaemia (20), hypotension (18), and hyperkalaemia (11). Respiratory and general reports include dyspnoea (13), pneumonia (13), and nausea (12).