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    Chemistry

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    Also known as: Cosyntropin, Tetracosactide, Cortrosyn (tn), Tetracosactrin, 16960-16-0, Tetracosactide acetate
    Molecular Formula
    C136H210N40O31S
    Molecular Weight
    2933.4  g/mol
    InChI Key
    ZOEFCCMDUURGSE-CQVUSSRSSA-N
    Tetracosactide
    A synthetic peptide that is identical to the 24-amino acid segment at the N-terminal of ADRENOCORTICOTROPIC HORMONE. ACTH (1-24), a segment similar in all species, contains the biological activity that stimulates production of CORTICOSTEROIDS in the ADRENAL CORTEX.
    1 2D Structure

    Tetracosactide

    2 Identification
    2.1 Computed Descriptors
    2.1.1 IUPAC Name
    (2S)-1-[(2S)-2-[[(2S)-2-[[(2S)-6-amino-2-[[(2S)-2-[[(2S)-1-[(2R)-2-[[(2R)-2-[[(2R)-6-amino-2-[[(2R)-6-amino-2-[[2-[[(2S)-2-[[(2S)-1-[(2S)-6-amino-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[(2-amino-3-hydroxypropanoyl)amino]-3-(4-hydroxyphenyl)propanoyl]amino]-3-hydroxypropanoyl]amino]-4-methylsulfanylbutanoyl]amino]-4-carboxybutanoyl]amino]-3-(1H-imidazol-4-yl)propanoyl]amino]-3-phenylpropanoyl]amino]-5-carbamimidamidopentanoyl]amino]-3-(1H-indol-3-yl)propanoyl]amino]acetyl]amino]hexanoyl]pyrrolidine-2-carbonyl]amino]-3-methylbutanoyl]amino]acetyl]amino]hexanoyl]amino]hexanoyl]amino]-5-carbamimidamidopentanoyl]amino]-5-carbamimidamidopentanoyl]pyrrolidine-2-carbonyl]amino]-3-methylbutanoyl]amino]hexanoyl]amino]-3-methylbutanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]pyrrolidine-2-carboxylic acid
    2.1.2 InChI
    InChI=1S/C136H210N40O31S/c1-75(2)109(127(200)154-71-106(181)156-88(31-13-17-52-137)114(187)158-89(32-14-18-53-138)115(188)159-91(35-21-56-149-134(142)143)116(189)164-96(37-23-58-151-136(146)147)131(204)175-60-25-39-104(175)126(199)173-111(77(5)6)128(201)163-90(33-15-19-54-139)120(193)171-110(76(3)4)129(202)169-101(65-80-43-47-84(180)48-44-80)132(205)176-61-26-40-105(176)133(206)207)172-125(198)103-38-24-59-174(103)130(203)95(34-16-20-55-140)157-107(182)70-153-113(186)99(66-81-68-152-87-30-12-11-29-85(81)87)167-117(190)92(36-22-57-150-135(144)145)160-121(194)98(63-78-27-9-8-10-28-78)166-123(196)100(67-82-69-148-74-155-82)168-118(191)93(49-50-108(183)184)161-119(192)94(51-62-208-7)162-124(197)102(73-178)170-122(195)97(165-112(185)86(141)72-177)64-79-41-45-83(179)46-42-79/h8-12,27-30,41-48,68-69,74-77,86,88-105,109-111,152,177-180H,13-26,31-40,49-67,70-73,137-141H2,1-7H3,(H,148,155)(H,153,186)(H,154,200)(H,156,181)(H,157,182)(H,158,187)(H,159,188)(H,160,194)(H,161,192)(H,162,197)(H,163,201)(H,164,189)(H,165,185)(H,166,196)(H,167,190)(H,168,191)(H,169,202)(H,170,195)(H,171,193)(H,172,198)(H,173,199)(H,183,184)(H,206,207)(H4,142,143,149)(H4,144,145,150)(H4,146,147,151)/t86?,88-,89-,90+,91-,92+,93+,94+,95+,96-,97+,98+,99+,100+,101+,102+,103+,104+,105+,109+,110+,111+/m1/s1
    2.1.3 InChI Key
    ZOEFCCMDUURGSE-CQVUSSRSSA-N
    2.1.4 Canonical SMILES
    CC(C)C(C(=O)NCC(=O)NC(CCCCN)C(=O)NC(CCCCN)C(=O)NC(CCCNC(=N)N)C(=O)NC(CCCNC(=N)N)C(=O)N1CCCC1C(=O)NC(C(C)C)C(=O)NC(CCCCN)C(=O)NC(C(C)C)C(=O)NC(CC2=CC=C(C=C2)O)C(=O)N3CCCC3C(=O)O)NC(=O)C4CCCN4C(=O)C(CCCCN)NC(=O)CNC(=O)C(CC5=CNC6=CC=CC=C65)NC(=O)C(CCCNC(=N)N)NC(=O)C(CC7=CC=CC=C7)NC(=O)C(CC8=CNC=N8)NC(=O)C(CCC(=O)O)NC(=O)C(CCSC)NC(=O)C(CO)NC(=O)C(CC9=CC=C(C=C9)O)NC(=O)C(CO)N
    2.1.5 Isomeric SMILES
    CC(C)[C@@H](C(=O)NCC(=O)N[C@H](CCCCN)C(=O)N[C@H](CCCCN)C(=O)N[C@H](CCCNC(=N)N)C(=O)N[C@H](CCCNC(=N)N)C(=O)N1CCC[C@H]1C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCCN)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC2=CC=C(C=C2)O)C(=O)N3CCC[C@H]3C(=O)O)NC(=O)[C@@H]4CCCN4C(=O)[C@H](CCCCN)NC(=O)CNC(=O)[C@H](CC5=CNC6=CC=CC=C65)NC(=O)[C@H](CCCNC(=N)N)NC(=O)[C@H](CC7=CC=CC=C7)NC(=O)[C@H](CC8=CNC=N8)NC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CCSC)NC(=O)[C@H](CO)NC(=O)[C@H](CC9=CC=C(C=C9)O)NC(=O)C(CO)N
    2.2 Synonyms
    2.2.1 MeSH Synonyms

    1. 1-24-acth

    2. 1-24-corticotropin

    3. Acth (1-24)

    4. Acth 1-24

    5. Acth, Synthetic

    6. Corticotropin (1-24)-peptide

    7. Corticotropin (1-24)-tetracosapeptide

    8. Cortosyn

    9. Cosyntropin

    10. Synthetic Acth

    11. Tetracosactide

    12. Tetracosactrin

    13. Tetracosapeptide

    2.2.2 Depositor-Supplied Synonyms

    1. Cosyntropin

    2. Tetracosactide

    3. Cortrosyn (tn)

    4. Tetracosactrin

    5. 16960-16-0

    6. Tetracosactide Acetate

    7. Cosyntropin (usp)

    8. Adrenocorticotropic Hormone Fragment 1-24 Human, Rat

    9. Schembl720535

    10. Gtpl6965

    11. D00284

    2.3 Create Date
    2007-07-03
    3 Chemical and Physical Properties
    Molecular Weight 2933.4 g/mol
    Molecular Formula C136H210N40O31S
    XLogP3-7.9
    Hydrogen Bond Donor Count42
    Hydrogen Bond Acceptor Count41
    Rotatable Bond Count96
    Exact Mass2932.5839961 g/mol
    Monoisotopic Mass2931.5806412 g/mol
    Topological Polar Surface Area1180 Ų
    Heavy Atom Count208
    Formal Charge0
    Complexity6500
    Isotope Atom Count0
    Defined Atom Stereocenter Count21
    Undefined Atom Stereocenter Count1
    Defined Bond Stereocenter Count0
    Undefined Bond Stereocenter Count0
    Covalently Bonded Unit Count1
    4 Drug and Medication Information
    4.1 Therapeutic Uses

    Cosyntropin is used as an aid in the diagnosis of adrenocortical insufficiency. The 30-minute cosyntropin test provides a good method of screening for primary adrenocortical insufficiency (Addison's disease) and is preferable to corticotropin for rapid screening since it is less likely to cause allergic reactions. When a greater stimulus to the adrenal cortex is desired, corticotropin or cosyntropin may be administered by IV infusion. If subnormal increases in plasma cortisol concentrations occur following administration of corticotropin or cosyntropin, additional tests providing prolonged stimulation of the adrenal cortex are required before impaired adrenocortical function can be diagnosed precisely and differentiation between primary and secondary adrenocortical insufficiency can be established. /Included in US product label/

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

    Investigationally, long-acting IM depot cosyntropin preparations have been used as an aid in the diagnosis of adrenocortical insufficiency and, in patients with normal adrenocortical function, in the long-term management of chronic inflammatory and degenerative disorders that are responsive to glucocorticoids. /NOT included in US product label/

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

    /Experimental therapy/ ... The outcome of children with cryptogenic infantile spasms treated with high-dose synthetic adrenocorticotropic hormone (ACTH) and the relation between early treatment, within 1 month of onset, and outcome /were evaluated/. The long-term cognitive and seizure outcomes of 37 patients with cryptogenic infantile spasms (onset, age 3 to 9 months) receiving standardized treatment regimen of high-dose tetracosactide depot, 1 mg IM every 48 h for 2 weeks, with a subsequent 8- to 10-week slow taper and followed by oral prednisone, 10 mg/day for a month, with a subsequent slow taper for 5 months or until the infant reached the age of 1 year, whichever came later /were assessed/ . Development was assessed before treatment. Seizure outcomes were followed up prospectively. Cognitive outcomes were determined after 6 to 21 years and analyzed in relation to treatment lag and pretreatment regression. Twenty-two infants were treated within 1 month of onset of infantile spasms, and 15 after 1 to 6.5 months. Normal cognitive outcome was found in all 22 (100%) patients of the early-treatment group, and in 40% of the late-treatment group. Normal cognitive outcome was found in all 25 (100%) patients who had no or only mild mental deterioration at presentation, including four in the late-treatment group but in only three of the 12 patients who had had marked or severe deterioration before treatment. Early treatment of cryptogenic infantile spasms with a high-dose ACTH protocol is associated with favorable long-term cognitive outcomes. Once major developmental regression lasts for a month or more, the prognosis for normal cognitive outcome is poor. Further studies are needed on the optimal treatment regimen for this disorder.

    PMID:15009227 Kivity S et al; Epilepsia 45 (3): 255-62 (2004).

    Indications: Acute exacerbations in patients suffering from multiple sclerosis. Hypsarrhythmia, and or infantile spasms. /Tetracosactrin zinc phosphate complex - depot (NOT available in US)/

    Prescribing Information for Synacthen Depot (tetracosactrin zinc phosphate complex); Novartis Pharmaceuticals Australia Pty Ltd (June 2005). Available from, as of March 22, 2010: https://www.novartis.com.au/PI_PDF/synd.pdf

    4.2 Drug Warning

    Cosyntropin is less antigenic than corticotropin and is less likely to produce allergic reactions than is corticotropin; however, hypersensitivity reactions have occurred rarely. Patients known to be sensitized to corticotropin and who have markedly positive skin tests usually react negatively when tested intradermally with cosyntropin. Some patients who are hypersensitive to corticotropin preparations may be able to tolerate cosyntropin, but cross-sensitivity reactions may occur. The possibility of hypersensitivity reactions should be considered in all patients receiving cosyntropin, especially in those with preexisting allergic diseases and/or a history of allergic reactions to corticotropin. Patients should be carefully observed for hypersensitivity reactions during and after administration of cosyntropin.

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

    Since Cortrosyn (cosyntropin) for Injection is intended for diagnostic and not therapeutic use, adverse reactions other than a rare hypersensitivity reaction are not anticipated. A rare hypersensitivity reaction usually associated with a pre-existing allergic disease and/or a previous reaction to natural ACTH is possible. Symptoms may include slight whealing with splotchy erythema at the injection site. There have been rare reports of anaphylactic reaction. The following adverse reactions have been reported in patients after the administration of Cortrosyn and the association has been neither confirmed nor refuted: bradycardia, tachycardia, hypertension, peripheral, edema, rash.

    US Natl Inst Health; DailyMed. Current Medication Information for CORTROSYN (cosyntropin) injection, powder, for solution (May 2006). Available from, as of February 24, 2010: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=3164

    FDA Pregnancy Risk Category: C /RISK CANNOT BE RULED OUT. Adequate, well controlled human studies are lacking, and animal studies have shown risk to the fetus or are lacking as well. There is a chance of fetal harm if the drug is given during pregnancy; but the potential benefits may outweigh the potential risk./

    US Natl Inst Health; DailyMed. Current Medication Information for CORTROSYN (cosyntropin) injection, powder, for solution (May 2006). Available from, as of February 24, 2010: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=3164

    It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Cortrosyn (cosyntropin) for Injection is administered to a nursing woman.

    US Natl Inst Health; DailyMed. Current Medication Information for CORTROSYN (cosyntropin) injection, powder, for solution (May 2006). Available from, as of February 24, 2010: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=3164

    For more Drug Warnings (Complete) data for Cosyntropin (15 total), please visit the HSDB record page.

    5 Pharmacology and Biochemistry
    5.1 MeSH Pharmacological Classification

    Hormones

    Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various ENDOCRINE GLANDS and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. (See all compounds classified as Hormones.)

    5.2 FDA Pharmacological Classification
    5.2.1 Pharmacological Classes
    Adrenocorticotropic Hormone [EPC]; Adrenocorticotropic Hormone [CS]
    5.3 ATC Code

    H - Systemic hormonal preparations, excl. sex hormones and insulins

    H01 - Pituitary and hypothalamic hormones and analogues

    H01A - Anterior pituitary lobe hormones and analogues

    H01AA - Acth

    H01AA02 - Tetracosactide

    5.4 Absorption, Distribution and Excretion

    Cosyntropin is rapidly absorbed following IM administration.

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

    Adsorption of tetracosactrin on to zinc phosphate provides for sustained release of the active substance from the intramuscular injection site. After an injection of a mg Synacthen Depot IM, the radioimmunologically determined plasma concentrations of tetracosactrin lie for 12 hours between 200 and 300 pg/mL. Tetracosactrin has an apparent distribution volume of approximately 0.4 L/kg. /Tetracosactrin zinc phosphate complex - depot (NOT available in US)/

    Prescribing Information for Synacthen Depot (tetracosactrin zinc phosphate complex); Novartis Pharmaceuticals Australia Pty Ltd (June 2005). Available from, as of March 22, 2010: https://www.novartis.com.au/PI_PDF/synd.pdf

    The precise distribution and metabolic fate of cosyntropin is not known, but the drug is rapidly removed from the plasma by many tissues. Cosyntropin apparently does not cross the placenta.

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

    5.5 Mechanism of Action

    Cosyntropin elicits all the pharmacologic responses usually produced by endogenous corticotropin; however, cosyntropin is immunologically much less active than corticotropin since most of the antigenic activity of corticotropin has been attributed to the C-terminal portion of the molecule (i.e., the 22-39 amino acid residues). In patients with normal adrenocortical function, cosyntropin stimulates the adrenal cortex to secrete cortisol (hydrocortisone), corticosterone, several weakly androgenic substances, and to a very limited extent aldosterone. When cosyntropin is used diagnostically, the effect of the drug is usually measured by determining plasma cortisol concentrations prior to and following administration of the drug. In patients with primary adrenocortical insufficiency (Addison's disease), cosyntropin does not substantially increase plasma cortisol concentrations.

    American Society of Health System Pharmacists; AHFS Drug Information 2009. Bethesda, MD. (2009)

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Import","activeIngredients":"","year":"2023","qtr":"Q4","strtotime":1699900200,"product":"API TETRACOSACTIDE HEXAACETATE (TEST LIC: TL\/BDZ\/23\/000217 DT:02.08.2023)(SAMPLE, NOT FOR SALE)","address":"VILLAGE THANTHEWAL, ROPAR ROAD,","city":"","supplier":"ATNAHS PHARMA UK LIMITED","supplierCountry":"SWITZERLAND","foreign_port":"LONDON - HEATHROW","customer":"IMMACULE LIFESCIENCES P. LTD.","customerCountry":"INDIA","quantity":"0.13","actualQuantity":"127.45","unit":"GMS","unitRateFc":"1804.3","totalValueFC":"285277.3","currency":"GBP","unitRateINR":"186389.1","date":"14-Nov-2023","totalValueINR":"23755294.63","totalValueInUsd":"285277.3","indian_port":"Delhi Air","hs_no":"29371900","bill_no":"8763482","productDescription":"API","marketType":"REGULATED MARKET","country":"SWITZERLAND","selfForZScoreResived":"Pharma Grade","supplierPort":"LONDON - HEATHROW","supplierAddress":"SOVEREIGN HOUSE MILES GRAY ROAD BASILDON ESSEX SS14 3FR BASILDON, , UNITED KINGDOM UNITED KINGDOM","customerAddress":"VILLAGE THANTHEWAL, ROPAR ROAD,"},{"dataSource":"API Import","activeIngredients":"","year":"2024","qtr":"Q1","strtotime":1710354600,"product":"TETRACOSACTIDE (CAS NO 60189-34-6) (1 GMS)","address":"NIKITA BAUNGLOW, NEAR PRAGATI","city":"GUJARAT","supplier":"BCN PEPTIDES","supplierCountry":"SPAIN","foreign_port":"BARCELONA","customer":"APOTHECON PHARMACEUTICALS","customerCountry":"INDIA","quantity":"0.00","actualQuantity":"0.001","unit":"KGS","unitRateFc":"2500000","totalValueFC":"2766.9","currency":"EUR","unitRateINR":"229750000","date":"14-Mar-2024","totalValueINR":"229750","totalValueInUsd":"2766.9","indian_port":"Bombay Air","hs_no":"29371900","bill_no":"2572451","productDescription":"API","marketType":"REGULATED MARKET","country":"SPAIN","selfForZScoreResived":"Pharma Grade","supplierPort":"BARCELONA","supplierAddress":"PI ELS VINYETS I ELS FOGAR SANT QUINTI DE ME B 08777 ., , SPAINSDNF SPAIN","customerAddress":"NIKITA BAUNGLOW, NEAR PRAGATI"}]
    14-Sep-2021
    14-Mar-2024
    KGS
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