Acthar Gel

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Acthar® Gel is an analog of adrenocorticotropic hormone (ACTH) that is used for the treatment of lupus flares and general lupus maintenance. An analog is a drug that is designed to mimic the effects of a naturally occurring substance in the body.1

Acthar Gel is injected into a muscle or under the skin. It can be used with or without other medicines for the treatment of lupus.1

Actha Gel is also used to treat other conditions, including:1

What are the ingredients in Acthar Gel?

The active ingredient in Acthar Gel is corticotropin.1

How does Acthar Gel work?

Acthar Gel is an analog of ACTH. This means it acts in the same manner as ACTH within the body. ACTH is a signaling hormone made in the brain. It travels to the adrenal glands on top of the kidneys and increases the production of other hormones, including cortisol, corticosterone, and aldosterone. These hormones play a role in the inflammatory response, including potentially reducing inflammation. This may help control or reduce lupus-related symptoms and damage.1

What are the possible side effects?

The most common side effects of Acthar Gel include:1

  • Reactions at the injection site
  • Tiredness
  • Weakness
  • Fluid retention
  • Trouble sleeping
  • Headache
  • Increased blood sugar levels

Do not start taking Acthar Gel if you have any type of infection unless your doctor tells you to. Contact your doctor right away if you have any signs of an infection, such as:1

  • Fever
  • Cough
  • Diarrhea
  • Flu-like symptoms
  • Feeling very tired

These are not all the possible side effects of Acthar Gel. Talk to your doctor about what to expect when taking Acthar Gel. You also should call your doctor if you have any changes that concern you when taking Acthar Gel.

Other things to know

People taking Acthar Gel should not receive certain vaccines. Talk to your doctor before getting any vaccine to understand which ones you need to avoid.1

Do not take Acthar Gel if you have any of the following conditions:1

  • Systemic fungal infections
  • Osteoporosis (thinning of the bones)
  • Scleroderma
  • Stomach ulcers
  • Uncontrolled high blood pressure
  • Congestive heart failure
  • Ocular herpes simplex
  • Sensitivity to certain protein products (including porcine proteins)
  • Adrenocortical hyperfunction or insufficiency (issues with the adrenal glands)

Long-term treatment with Acthar Gel may impact the body’s normal regulation of hormones. Do not stop taking Acthar Gel or change your dose without first talking with your doctor. Signs of a hormonal disruption related to Acthar Gel include:1

  • Weight loss
  • Decreased appetite
  • Pale skin
  • Stomach pain or changes in bathroom habits
  • Weakness
  • Fatigue
  • Fever
  • An overall feeling of being ill

Since Acthar Gel mimics a hormone that increases cortisol, it can cause or worsen corticosteroid-related side effects. You should be monitored for Cushing’s Syndrome (too much cortisol) while taking Acthar Gel. Common signs of Cushing’s syndrome include:1

  • Rounded, puffy face
  • Thin skin with easy bruising
  • Stretch marks on the stomach, arms, thighs, or other areas
  • Weight gain
  • Increased body fat around the neck
  • Weak bones
  • High blood pressure

While taking Acthar Gel you should also be monitored for:1

  • High blood pressure
  • Low potassium levels
  • Behavior or mood changes
  • Decreases in bone density (strength)

Acthar Gel may increase your risk of developing eye issues or gastrointestinal ulcers. People with conditions like myasthenia gravis, diabetes, thyroid issues, or liver cirrhosis may experience a worsening of these conditions while taking Acthar Gel.1

Acthar Gel can harm an unborn baby. Talk to your doctor if you are pregnant or planning to become pregnant before taking Acthar Gel.1

Before starting Acthar Gel, tell your doctor if you have or have had:1

  • Diabetes
  • Heart, kidney, thyroid, stomach, or liver problems
  • Recent infection
  • Recent surgery
  • Neuromuscular problems, convulsions, or seizures
  • Been exposed to someone with tuberculosis (TB)
  • Are taking any other medications, including medications called diuretics

Before beginning treatment for lupus, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Acthar Gel.

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