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Cosyntropin

Also known as: Cortrosyn, ACTH 1-24, Tetracosactide

At a glance

PeptiGuide dataset · reviewed Aug 2026

What it is

Synthetic ACTH 1-24 peptide used to evaluate adrenal cortisol response.

Status

FDA Approved

Typical dose

250mcg

Researched for

Adrenal function testing, diagnostic use

Trial progress

  1. PrePreclinical
  2. IPhase I
  3. IIPhase II
  4. IIIPhase III
  5. IVPhase IV
  6. FDAFDA approved

FDA approved - FDA-approved for specific uses with established human evidence

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  • Synthetic ACTH 1-24 fragment used for adrenal function testing.
  • Source status: FDA Approved; clinical status: FDA Approved - Diagnostic use.
  • Administration is listed as IV or intramuscular, with community dose data described as limited.
  • Research/label dosing row lists 250 mcg IV/IM as a standard single diagnostic dose.
  • Researched for adrenal function testing and diagnostic use.

Cosyntropin is the 1-24 amino-acid portion of ACTH, while endogenous ACTH is described as 39 amino acids long. The source reports that this fragment activates the melanocortin-2 receptor on adrenal cortex cells, which can produce a rapid cortisol rise; the diagnostic value comes from observing whether the adrenal response occurs as expected.

Where the research stands

The source characterizes cosyntropin as an FDA-approved, clinically established diagnostic agent. It reports a standard adult diagnostic dose of 250 micrograms, also expressed as 0.25 mg, administered IV or intramuscularly. The described testing approach measures serum cortisol before dosing and again at 30 and 60 minutes. A response reaching roughly 18 micrograms per deciliter is described as generally normal, while assay choice can shift thresholds, including lower cutoffs with LC-MS/MS. A weak cortisol rise may support adrenal insufficiency assessment, with the source distinguishing primary adrenal disease from possible secondary or tertiary causes and noting interpretation caveats. The evidence focus is diagnostic accuracy and test interpretation, not therapeutic benefit.

What it shows

Human clinical evidence

FDA-approved for specific uses with established human evidence

Limitations

Use only according to approved labeling and qualified medical guidance.

Bottom line: FDA Approved - Diagnostic use FDA Approved

Typical dosing

Community

Limited community data available

See research protocols

Range: See research dosing

Research dosing

Indication-specific

Doses observed in studies

250 mcg IV/IM (standard)

FDA Approved Labeling - Prescribed dose

Use only according to approved labeling and qualified medical guidance.

Duration
Single diagnostic dose
Administration
IV or intramuscular

Best time to take

Morning or as directed

Follow recommended protocol

Food recommendation

With or without food

Why this timing?

The source gives protocol-following as the timing guidance and notes that timing may depend on response and goals; it also emphasizes consistent timing over a particular clock time.

Not everyone experiences these. Individual responses vary with dose, duration, and personal factors.

  • Hypersensitivity reactions
  • Injection site reactions
  • Bradycardia or tachycardia
  • Blood pressure changes
  • Headache
  • Intended for diagnostic use
  • FDA approved (Cortrosyn)

Not everyone experiences side effects, and severity can vary by context, purity, route, and individual health factors.

SYSMEHFRWGKPVGKKRRPVKVYP (ACTH 1-24)

One open dataset

Every fact on this page - doses, side effects, references - comes from the same PeptiGuide dataset that powers the Tracker, Compare, and the Lab.

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Educational resource, not medical advice. Talk to your clinician before acting on anything here.

Community discussion

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