Tetracosactide
Tetracosactide (Cosyntropin) is the pure, synthetic recreation of the first 24 amino acids of the human Adrenocorticotropic Hormone (ACTH)—the exact sequence holding 100% of the molecule's biological firepower. It is the absolute clinical standard for aggressive diagnostic interrogation of the adrenal glands, utilized instantly in emergency and endocrine settings to forcefully test the maximum acute cortisol-producing capacity of a failing adrenal cortex.
Quick Stats
Scientific Data
Mechanism of Action
Tetracosactide (also known as cosyntropin or Synacthen) is a synthetic peptide consisting of the first 24 amino acids of adrenocorticotropic hormone (ACTH). The full human ACTH has 39 amino acids, but biological activity resides entirely in the N-terminal 24 sequence.
Tetracosactide stimulates the adrenal cortex to rapidly produce cortisol and other corticosteroids. It is primarily used clinically as a rapid diagnostic test (the Synacthen Test) for adrenal insufficiency. Unlike long-term corticosteroid therapy, it relies on the body's own adrenal steroidogenic pathways.
Source: PMID: 6765449
Background & History
Tetracosactide (cosyntropin/Synacthen) is an essential diagnostic tool in endocrinology. The ACTH stimulation test has been the gold standard for diagnosing adrenal insufficiency for over 50 years. The short Synacthen test takes only 1 hour and can be performed in outpatient settings. Depot formulations (Synacthen Depot) have also been used therapeutically for infantile spasms and inflammatory conditions in various countries.
Research Use Cases
- ✓Adrenal insufficiency diagnosis
- ✓ACTH stimulation test
- ✓Infantile spasms (depot form)
- ✓Therapeutic use in inflammatory conditions
Dosing Protocol
| Typical Dose | 250 mcg IV/IM (diagnostic) |
| Frequency | Single dose (ACTH stimulation test) |
| Half-Life | 0.25 hours |
Dosing Protocols
Diagnostic (Synacthen Test)
Therapeutic (Rare)
Body-Weight Dosing Reference
Estimated doses extrapolated from the published research range of 250–250 mcg/day (referenced to 70 kg / 154 lb). These are approximations — consult a qualified healthcare provider for personalised guidance.
| Weight | Low Dose | Target Dose | High Dose |
|---|---|---|---|
| 120 lb(54 kg) | 193 mcg | 193 mcg | 193 mcg |
| 140 lb(63 kg) | 225 mcg | 225 mcg | 225 mcg |
| 160 lb(73 kg) | 261 mcg | 261 mcg | 261 mcg |
| 180 lb(82 kg) | 293 mcg | 293 mcg | 293 mcg |
| 200 lb(91 kg) | 325 mcg | 325 mcg | 325 mcg |
| 220 lb(100 kg) | 357 mcg | 357 mcg | 357 mcg |
| 250 lb(113 kg) | 404 mcg | 404 mcg | 404 mcg |
💉 For exact syringe units based on your vial concentration, use the Tetracosactide Reconstitution Calculator →
Administration
Expected Timeline
Who Is It For?
Adrenal Function Testing
HighThe gold-standard diagnostic tool for Addison's disease and HPA axis evaluation.
Safety & Considerations
FDA-approved. Mostly used in supervised clinical settings for single-dose diagnosis. Therapeutic use carries risks similar to chronic corticosteroid exposure.
Regulatory & Legal Status
Not currently on the WADA 2026 Prohibited List. Policies may change — verify before competition.
Research Chemical
US Compounding: Not eligible / not available
⚠️ This information is for educational purposes only and may not reflect the most current regulatory updates. Always verify with official FDA, WADA, and jurisdiction-specific sources before use.
Interactions & Contraindications
Exogenous corticosteroids will blunt the cortisol response and should be withheld before testing. Dexamethasone does not cross-react with cortisol assays.
Dosing Quick Reference
Frequently Asked Questions
What is the Synacthen test?▼
References
- Dorin RI et al. “"The standard short Synacthen test in adrenal insufficiency".” Annals of Internal Medicine (2003). PMID: 12860585
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