688:
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
612:
168:
1070:
1031:
244:
1233:
Mallinckrodt acquired the US rights to the animal-derived form via its acquisition of
Questcor Pharmaceuticals in 2014. When Questcor acquired the drug in 2001 it sold for $ 40 a vial; within a year of the acquisition Questcor raised the price of the drug to $ 1,500 per vial and to $ 28,000 by 2013.
949:
In addition, the US label for corticotropin for therapeutic uses includes contraindications for people who have recently had surgery, and people with scleroderma, osteoporosis, uncontrolled hypertension, or sensitivity to proteins of porcine origin; in addition the infection diseases systemic fungal
1247:
acquired
Questcor and its drug portfolio, which included the worldwide rights to Synacthen Depot. Prior to the price increase, Mallinckrodt claims that the drug was manufactured at a loss. Some have claimed that the price increase is abusive. The drug had been priced at $ 33 but rose to $ 680 per
938:
In the US the only contraindication for tetracosactide for diagnostic use is hypersensitivity to ACTH but in the UK, regulators placed contraindications for hypersensitivity to ACTH and additionally, for people with allergic disorders including asthma, acute psychosis, infectious diseases, peptic
1238:
and attorneys general from five states sued
Mallinckrodt for anti-competitive behavior with regard to the acquisition of Synacthen Depot and the monopolistic pricing of Acthar, and in January 2017 the company settled, agreeing to pay $ 100 million and to license Synacthen Depot to a competitor.
1125:
agreed that ANI would purchase NDA 009854 and NDA 008975 and related trademarks and other assets related to these two versions of corticotrophin from Merck for $ 75M and ongoing royalties; the transaction closed in
January 2016. As of November 2016 ANI was preparing its supplemental NDA to get
1224:
As of 2007, it was widely reported that tetracosactide had been used as an illegal performance-enhancing drug by professional cyclists. It is known to be used as a doping agent to increase the secretion of glucocorticoids by adrenal glands.
982:
concentrations in 30 minutes. If the adrenal glands appear not to be working then tetracosactide injection can be given to check whether the problem is due to diseased or damaged adrenals or due to lack of pituitary ACTH.
950:
infection, ocular herpes simplex, and infants who have congenital infections are specified. The label also notes that people taking corticotropin for immunosuppression should not be given live vaccines.
1242:
In Canada, Synacthen Depot's pricing increased by 2000% in 2015, causing some provincial single payer authorities to delist the drug from funded medications. The increase in the drug's price came after
1239:
According to Kaiser Health News, Mallinckrodt responded by increasing its
Congressional lobbying to $ 610,000, and its contributions to Congress members to $ 44,000, in the first quarter of 2017.
2338:
820:
Both corticotropin and tetracosactide have been used for therapeutic purposes. In the US the tetracosactide label is limited to diagnosis but the UK label provides for therapeutic uses.
2401:
946:
The same contraindications that were applied in the UK for diagnostic use of tetracosactide, apply for therapeutic use of both tetracosactide and corticotropin in the US and UK.
2368:
1208:
In the UK, available forms of tetracosactide/cosyntropin, the synthetic form of corticotrophin, have been approved for both therapeutic and diagnostic uses, and have included:
2113:
1121:
formulation as well as in a zinc hydrochloride formulation, each first approved in the US in 1955 and subsequently discontinued. In
September 2015 ANI Pharmaceuticals and
1234:
In 2013, Questcor acquired the US rights to a competing product, Synacthen Depot, from
Novartis. In 2014 Mallinckrodt raised the price of Acthar further to $ 34,000. The
2481:
1147:
A corticotrophin was approved in 1957 under NDA 010831, was subsequently discontinued, and as of
January 2017 was under control of Organics/Lagrange, a subsidiary of
1126:
approval to re-introduce this formulation; in 2015 ANI estimated that the US market for these products was about $ 1 billion per year, based on sales of Acthar gel.
1215:
A version branded
Synacthen, absorbed on to zinc phosphate, provided in milky white suspension, approved in 2008 and as of January 2017 controlled by Mallinckrodt.
1177:
In the US, available forms of tetracosactide/cosyntropin, the synthetic form of corticotrophin, have been approved only for diagnostic uses, and have included:
1248:
vial. As an off-patent pharmaceutical, a similar drug, differing in formulation, available in Europe, made by a different manufacturer, sells for $ 8 per vial.
106:
H-Ser-Tyr-Ser-Met-Glu-His-Phe-Arg-Trp-Gly-Lys-Pro-Val-Gly-Lys-Lys-Arg-Arg-Pro-Val-Lys-Val-Tyr-Pro-Asn-Gly-Ala-Glu-Asp-Glu-Ser-Ala-Glu-Ala-Phe-Pro-Leu-Glu-Phe-OH
1212:
A version branded
Synacthen and provided in solution 250 mcg ampoules, for diagnostic uses, approved in 2008 and as of January 2017 controlled by Mallinckrodt.
298:
910:
are usually used but for some reason should not be; some uses include use for people who do not respond to glucocorticoids or cannot tolerate them who have
711:
704:
958:
People taking corticotropin or tetracosactide are more likely to get infections, and are at risk of hypothalamic-pituitary-axis (HPA) suppression and
1140:
Corticotrophin branded as "Acthar", was first approved in 1950 and was subsequently discontinued; as of January 2017 this NDA was under control of
1129:
Corticotrophin, first approved in 1952 and subsequently discontinued; as of January 2017 this NDA was under control of Parkedale, a subsidiary of
3132:
2647:
2302:
Lathan P, Moore GE, Zambon S, Scott-Moncrieff JC (2008). "Use of a low-dose ACTH stimulation test for diagnosis of hypoadrenocorticism in dogs".
1690:"Form 8-K Exhibit 99.1: ANI Pharmaceuticals Reports Record Third Quarter Results and Year-To-Date 2016 Highlights and Narrows Full-year Guidance"
3157:
3152:
3122:
2672:
2667:
2474:
2346:
2066:
Chaabo A, de Ceaurriz J, Buisson C, Tabet JC, Lasne F (February 2011). "Simultaneous quantification and qualification of synacthen in plasma".
3083:
2951:
2764:
280:
51:
2886:
2833:
2154:
2412:
3147:
3137:
3127:
3117:
2662:
2652:
2642:
2637:
2132:
1159:
version under this NDA was approved under ANDA 088772 and was subsequently discontinued, and as of January 2017 was under the control of
1806:
3068:
3063:
3058:
2971:
2966:
2961:
2946:
2941:
2936:
2784:
2779:
2774:
2588:
2583:
2578:
3190:
2931:
2861:
2818:
2573:
2467:
2375:
2002:
1960:
1938:
1901:
1876:
1854:
1832:
1765:
1743:
1707:
1695:
1677:
1646:
1624:
3025:
3020:
2956:
2926:
2921:
2916:
2876:
2769:
2759:
2739:
2540:
2535:
2212:
3221:
1170:. A repository version of H.P. Acthar gel was approved in 2010 and as of January 2017 was also under the control of Mallinkrodt.
2195:
1080:
1041:
2050:
1426:
1382:
1346:
1310:
1197:, approved in 2012, and another for Amphastar under ANDA 016750. This version is a powder that is reconstituted before use.
1689:
1671:
1924:
21:
This article is about Adrenocorticotropic hormone as a medication and diagnostic agent. For as a natural hormone, see
1729:
680:
331:
98:
74:
3216:
3030:
2838:
2711:
2545:
1499:
489:
3226:
1985:
1166:
A corticotrophin called H.P. Acthar Gel was approved in 1952 and as of January 2017 was under the control of
919:
1672:"Form 8K, Exhibit 99.1: Press release: ANI Pharmaceuticals to Acquire Two NDAs from Merck for $ 75 Million"
856:
844:
806:
607:
540:
163:
3005:
2808:
2696:
2627:
2515:
2024:
1277:
974:
at the base of the brain. It acts on the adrenal glands to stimulate the production of steroid hormones (
22:
2439:
2172:
978:). If the adrenal glands are healthy, a single injection of tetracosactide results in a rise in blood
3078:
2911:
2754:
2603:
1186:
2453:
2443:
1235:
777:
of ACTH and retains full function of the parent peptide. Tetracosactide stimulates the release of
2226:
2173:"Pharma corp. hikes infant epilepsy drug price by 2,000%, from $ 33.05 per vial to $ 680 per vial"
2991:
2794:
2682:
2501:
1730:"King Pharmaceuticals, Inc. Form 10-K, Annual report for the fiscal year ended December 31, 2007"
256:
41:
1204:
and was approved under the 505b(2) pathway in 2008; as of January 2017 it had been discontinued.
2906:
2749:
2251:
Bomback AS, Tumlin JA, Baranski J, Bourdeau JE, Besarab A, Appel AS, et al. (March 2011).
1416:
840:
274:
Ser-Tyr-Ser-Met-Glu-His-Phe-Arg-Trp-Gly-Lys-Pro-Val-Gly-Lys-Lys-Arg-Arg-Pro-Val-Lys-Val-Tyr-Pro
1398:
1300:
529:
2490:
1810:
1273:
999:
959:
940:
863:; for severe acute and chronic allergic and inflammatory processes involving the eye such as
814:
790:
729:
589:
480:
29:
1130:
923:
836:
810:
549:
444:
805:
Both corticotropin and tetracosactide have been used for diagnostic purposes to determine
290:
8:
3195:
2215:, By Jay Hancock and Elizabeth Lucas and Sydney Lupkin, Kaiser Health News, July 24, 2017
2114:"Maker of $ 34,000-a-vial drug to pay $ 100 million for allegedly preventing competition"
852:
832:
435:
61:
611:
167:
2493:
2449:
2279:
2252:
2091:
1469:
1452:
1261:
1257:
915:
911:
900:
828:
751:
817:. However, as of 2015 the US label for corticotropin does not include diagnostic use.
2319:
2284:
2083:
2046:
1474:
1422:
1378:
1342:
1306:
1185:
and was approved by the FDA in 1970, and as of January 2017 was under the control of
725:
469:
129:
2315:
2095:
1788:
1338:
The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies
1200:
A version of cosyntropin in solution (as opposed to powder) was developed by Sandoz/
2459:
2311:
2274:
2264:
2075:
1464:
943:, treatment of primary adrenocortical insufficiency and adrenocongenital syndrome.
824:
624:
311:
180:
1595:
1529:
1372:
1336:
1114:
971:
907:
888:
848:
736:
3184:
3180:
2155:"Questcor's Acthar maneuvers land Mallinckrodt in hot water with FTC, state AGs"
906:
In the UK tetracosactide is used for short-term therapy in conditions for which
3142:
3053:
2866:
2734:
2657:
2568:
1530:"Synacthen Ampoules 250 micrograms per ml - Summary of Product Characteristics"
1174:
Synthetic forms were created as a replacement for the animal-derived products.
1122:
987:
975:
927:
884:
860:
843:; in acute exacerbations or as maintenance therapy for collagen disorders like
778:
747:
235:
2079:
3210:
3015:
3010:
2891:
2828:
2813:
2706:
2701:
2613:
2530:
2520:
2339:"Consider ACTH stimulation test when you suspect canine hyperadrenocorticism"
2253:"Treatment of nephrotic syndrome with adrenocorticotropic hormone (ACTH) gel"
1453:"H.p. Acthar gel and cosyntropin review: clinical and financial implications"
1003:
995:
872:
794:
786:
600:
156:
2213:
Follow The Money: Drugmakers Deploy Political Cash As Prices And Anger Mount
3048:
2856:
2729:
2563:
2323:
2288:
2196:"Company Raises the Price of a Drug That Fights Infant Epilepsy by 85,000%"
2087:
1478:
1244:
1167:
1156:
1109:
In the US, available forms of animal-derived corticotrophin have included:
306:
1568:"US Label: H.P. Acthar Gel (repository corticotropin) and (corticotropin)"
1567:
2871:
1152:
892:
880:
2269:
1069:
1030:
509:
3176:
2525:
1181:
A branded version called Cortrosyn, which was created and developed by
1015:
774:
660:
520:
216:
140:
2240:"Monday November 16th 2015". The National. CBC News. 16 November 2015.
1596:"Synacthen Depot Ampoules 1mg/ml - Summary of Product Characteristics"
3112:
2823:
2632:
2593:
1374:
Concise Dictionary of Pharmacological Agents: Properties and Synonyms
864:
455:
284:
115:
55:
1201:
1194:
991:
979:
782:
569:
500:
3042:
3038:
3034:
2850:
2846:
2842:
2723:
2719:
2715:
2557:
2553:
2549:
2881:
1182:
1160:
876:
744:
243:
2301:
1922:
Organon sold the rights to Cortrosyn to Amphastar in 2003, per
1148:
1141:
1134:
1014:
The synthetic form consists of the first 24 (of a total of 39)
868:
1256:
Acthar gel has been proposed as a therapy to treat refractory
3093:
2981:
2250:
2065:
1190:
1189:, and there were three generic versions under ANDAs, one for
896:
580:
2896:
2227:"2,000% price hike for infant seizure drug called 'absurd'"
560:
2017:
1272:
Both versions of the hormone are also used to perform the
1980:
1978:
1590:
1588:
1586:
1584:
1582:
1580:
1450:
1118:
1018:
of ACTH and retains full function of the parent peptide.
1787:
Whalen J, Cimilluca D, McCracken J (28 September 2009).
1786:
1674:. ANI Pharmaceuticals via SEC Edgar. September 21, 2015.
1877:"NDA022432: H.P. Acthar Gel (Repository Corticotropin)"
1809:. Lincoln International. 14 August 2013. Archived from
1625:"NDA 009854: Purified corticotropin-zinc hydrochloride"
1524:
1522:
1520:
1377:. Springer Science & Business Media. pp. 84–.
1975:
1692:. ANI Pharmaceuticals via SEC Edgar. November 3, 2016.
1577:
1562:
1560:
1558:
1556:
1554:
1552:
1550:
1421:. Taylor & Francis. January 2000. pp. 1005–.
1305:. Taylor & Francis. January 2000. pp. 275–.
2489:
1517:
1494:
1492:
1490:
1488:
1547:
970:In the normal situation, ACTH is released from the
488:
1535:. UK Electronic Medicines Compendium. June 8, 2016
1295:
1293:
2034:
1533:(First approved 25 June 1998 under PL 43357/0001)
1485:
1451:Gettig J, Cummings JP, Matuszewski K (May 2009).
773:. It consists of the first 24 (of a total of 39)
3208:
1789:"Abbott to Buy Solvay Drug Unit for $ 7 Billion"
1599:(First approved 25 June 1998 under PL43357/0002)
1418:Index Nominum 2000: International Drug Directory
1366:
1364:
1362:
1360:
1358:
1302:Index Nominum 2000: International Drug Directory
468:
128:
1605:. Electronic Medicines Compendium. June 8, 2016
1446:
1444:
1442:
1440:
1438:
1290:
443:
2244:
2218:
46:Acortan, Acthar, Acton, Cortigel, Trofocortina
2475:
2402:"Demystifying Tests for Hyperadrenocorticism"
2148:
2146:
1855:"NDA 008372: H.P. Acthar Gel (Corticotropin)"
1355:
3143:Tetracosactide (tetracosactrin, cosyntropin)
2658:Tetracosactide (tetracosactrin, cosyntropin)
2133:"Questcor Finds Profits, at $ 28,000 a Vial"
2124:
2059:
1925:"Amphastar Pharmaceuticals S-1, Amendment 5"
1896:
1894:
1435:
2107:
2105:
82:In general: ℞ (Prescription only)
2482:
2468:
2143:
1953:
1931:
1825:
1666:
1664:
1370:
1330:
1328:
1326:
1324:
1322:
610:
528:
242:
166:
2452:at the U.S. National Library of Medicine
2442:at the U.S. National Library of Medicine
2399:
2278:
2268:
1995:
1891:
1869:
1847:
1758:
1736:
1700:
1647:"NDA 008975: Purified corticotrophin gel"
1639:
1617:
1468:
1264:due to a variety of glomerular diseases.
986:Tetracosactide stimulates the release of
823:In the US corticotropin is used to treat
548:
2102:
743:is a medication and naturally occurring
2304:Journal of Veterinary Internal Medicine
2130:
2111:
2040:
1807:"Press Release - Lincoln International"
1661:
1319:
757:The form that is made synthetically is
508:
3209:
2193:
2152:
2068:Analytical and Bioanalytical Chemistry
2041:Kimmage P (2007). "tour 87 stage 14".
1678:Form 8-K, filed 2015-09-21, index page
1371:Morton IK, Hall JM (6 December 2012).
1267:
1099:
891:, and anterior segment inflammation;
601:
157:
2463:
2336:
2224:
588:
289:
60:
2257:Drug Design, Development and Therapy
2045:. Yellow Jersey Press. p. 125.
1902:"NDA016750: Cortrosyn (Cosyntropin)"
1744:"NDA 007504: Acthar (Corticotropin)"
1334:
1064:
1025:
933:
310:
827:in infants, acute exacerbations of
735:The form that is purified from pig
568:
459:
119:
13:
2003:"NDA 022028: Cosyntropin solution"
1708:"NDA 008317: ACTH (Corticotropin)"
1500:"US Cortrosyn (cosyntropin) label"
953:
851:; for skin conditions like severe
14:
3238:
2433:
2025:"US Label: Cosyntropin Injection"
1193:approved in 2009, one for Sandoz/
1133:which is in turn a subsidiary of
1104:
939:ulcer, refractory heart failure,
1068:
1029:
1021:
641:
635:
197:
191:
3133:Norleusactide (pentacosactride)
2648:Norleusactide (pentacosactride)
2393:
2361:
2330:
2316:10.1111/j.1939-1676.2008.0118.x
2295:
2233:
2206:
2187:
2165:
2112:Johnson CY (January 18, 2017).
1916:
1799:
1780:
1722:
1682:
965:
800:
724:is used as a medication and as
693:Key:ZOEFCCMDUURGSE-CQVUSSRSSA-N
261:Cortrosyn, Synacthen, Nuvacthen
3222:Melanocortin receptor agonists
1927:. SEC Edgar. October 27, 2005.
1573:. Mallinckrodt. February 2015.
1409:
1391:
653:
647:
629:
209:
203:
185:
1:
2400:Gallagher A (November 2014).
1283:
920:juvenile rheumatoid arthritis
831:in adults; acute episodes of
750:produced and secreted by the
2337:Lyman R (November 1, 2008).
2225:Crowe K (16 November 2015).
2194:Galeon D (21 January 2017).
1986:"NDA 022028: Summary review"
1833:"ANDA 088772: Corticotropin"
1151:via Abbott's acquisition of
1113:Corticotrophin derived from
1009:
845:systemic lupus erythematosus
807:adrenocortical insufficiency
7:
3011:Afamelanotide (melanotan I)
2814:Afamelanotide (melanotan I)
2702:Afamelanotide (melanotan I)
2521:Afamelanotide (melanotan I)
2440:Adrenocorticotropic+Hormone
1766:"NDA 010831: Corticotropin"
1335:Elks J (14 November 2014).
1278:hypoadrenocorticism in dogs
1251:
895:in the lungs; and to treat
722:Adrenocorticotropic hormone
30:Adrenocorticotropic hormone
23:Adrenocorticotropic hormone
10:
3243:
3196:Proopiomelanocortin (POMC)
2153:Staton T (June 18, 2015).
1939:"ANDA 090574: Cosyntropin"
1228:
1060:
619:Chemical and physical data
175:Chemical and physical data
20:
3166:
3148:Tosactide (octacosactrin)
3102:
2990:
2793:
2681:
2663:Tosactide (octacosactrin)
2612:
2500:
2080:10.1007/s00216-010-4565-z
1991:. FDA. February 21, 2008.
1961:"ANDA 202147:Cosyntropin"
1219:
1187:Amphastar Pharmaceuticals
701:
676:
659:
623:
618:
599:
579:
559:
539:
519:
499:
479:
454:
434:
327:
322:
297:
279:
265:
255:
250:
241:
215:
179:
174:
155:
139:
114:
94:
89:
73:
68:
50:
40:
35:
2454:Medical Subject Headings
2444:Medical Subject Headings
2131:Pollack A (2012-12-29).
1236:Federal Trade Commission
857:Stevens–Johnson syndrome
752:anterior pituitary gland
291:International Drug Names
62:International Drug Names
3191:N-POMC (NPP, pro-γ-MSH)
2374:. Idexx. Archived from
2369:"ACTH Stimulation Test"
1077:This section is empty.
1038:This section is empty.
998:, and is used for the
841:ankylosing spondylitis
789:, and is used for the
3217:Medical controversies
2491:Melanocortin receptor
2030:. FDA. February 2008.
1571:(First approved 1952)
1274:ACTH stimulation test
1000:ACTH stimulation test
815:ACTH stimulation test
791:ACTH stimulation test
730:ACTH stimulation test
3227:Peptide therapeutics
3006:ACTH (corticotropin)
2809:ACTH (corticotropin)
2697:ACTH (corticotropin)
2628:ACTH (corticotropin)
2516:ACTH (corticotropin)
1280:and sometimes cats.
1155:'s drug business. A
1131:King Pharmaceuticals
924:rheumatoid arthritis
875:, diffuse posterior
837:rheumatoid arthritis
2270:10.2147/DDDT.S17521
1793:Wall Street Journal
1268:Veterinary medicine
1258:autoimmune diseases
1100:Society and culture
901:nephrotic syndromes
853:erythema multiforme
833:psoriatic arthritis
238:
32:
2175:. 16 November 2015
1813:on 2 February 2017
1262:nephrotic syndrome
960:Cushing's syndrome
941:Cushing's syndrome
912:ulcerative colitis
829:multiple sclerosis
809:, particularly in
374:-tryptophylglycyl-
234:
28:
3204:
3203:
2409:Clinicians' Brief
2052:978-0-224-08017-0
1428:978-3-88763-075-1
1384:978-94-011-4439-1
1348:978-1-4757-2085-3
1312:978-3-88763-075-1
1097:
1096:
1058:
1057:
934:Contraindications
811:Addison's disease
719:
718:
425:
421:
417:
413:
409:
405:
401:
397:
393:
389:
385:
381:
377:
373:
369:
365:
361:
357:
353:
349:
345:
341:
275:
232:
231:
16:Chemical compound
3234:
2484:
2477:
2470:
2461:
2460:
2427:
2426:
2424:
2423:
2417:
2411:. Archived from
2406:
2397:
2391:
2390:
2388:
2386:
2380:
2373:
2365:
2359:
2358:
2356:
2354:
2345:. Archived from
2334:
2328:
2327:
2310:(4): 1070–1073.
2299:
2293:
2292:
2282:
2272:
2248:
2242:
2241:
2237:
2231:
2230:
2222:
2216:
2210:
2204:
2203:
2191:
2185:
2184:
2182:
2180:
2169:
2163:
2162:
2150:
2141:
2140:
2128:
2122:
2121:
2109:
2100:
2099:
2074:(5): 1835–1843.
2063:
2057:
2056:
2038:
2032:
2031:
2029:
2021:
2015:
2014:
2012:
2010:
1999:
1993:
1992:
1990:
1982:
1973:
1972:
1970:
1968:
1957:
1951:
1950:
1948:
1946:
1935:
1929:
1928:
1920:
1914:
1913:
1911:
1909:
1898:
1889:
1888:
1886:
1884:
1873:
1867:
1866:
1864:
1862:
1851:
1845:
1844:
1842:
1840:
1829:
1823:
1822:
1820:
1818:
1803:
1797:
1796:
1784:
1778:
1777:
1775:
1773:
1762:
1756:
1755:
1753:
1751:
1740:
1734:
1733:
1726:
1720:
1719:
1717:
1715:
1704:
1698:
1693:
1686:
1680:
1675:
1668:
1659:
1658:
1656:
1654:
1643:
1637:
1636:
1634:
1632:
1621:
1615:
1614:
1612:
1610:
1603:medicines.org.uk
1600:
1592:
1575:
1574:
1572:
1564:
1545:
1544:
1542:
1540:
1534:
1526:
1515:
1514:
1512:
1510:
1504:
1496:
1483:
1482:
1472:
1448:
1433:
1432:
1413:
1407:
1406:
1395:
1389:
1388:
1368:
1353:
1352:
1332:
1317:
1316:
1297:
1117:from pigs, in a
1115:pituitary glands
1092:
1089:
1079:You can help by
1072:
1065:
1053:
1050:
1040:You can help by
1033:
1026:
825:epileptic spasms
761:, also known as
737:pituitary glands
726:diagnostic agent
715:
714:
707:
671:
669:
655:
649:
643:
637:
631:
614:
603:
592:
572:
552:
532:
512:
492:
472:
462:
461:
447:
423:
419:
415:
411:
407:
403:
399:
395:
391:
387:
383:
379:
375:
371:
367:
363:
359:
355:
351:
347:
343:
339:
314:
293:
273:
271:α corticotrophin
246:
239:
237:
233:
227:
225:
211:
205:
199:
193:
187:
170:
159:
132:
122:
121:
64:
33:
31:
27:
3242:
3241:
3237:
3236:
3235:
3233:
3232:
3231:
3207:
3206:
3205:
3200:
3162:
3098:
2995:
2986:
2798:
2789:
2686:
2677:
2617:
2608:
2505:
2496:
2488:
2436:
2431:
2430:
2421:
2419:
2415:
2404:
2398:
2394:
2384:
2382:
2378:
2371:
2367:
2366:
2362:
2352:
2350:
2349:on July 4, 2018
2335:
2331:
2300:
2296:
2249:
2245:
2239:
2238:
2234:
2223:
2219:
2211:
2207:
2192:
2188:
2178:
2176:
2171:
2170:
2166:
2151:
2144:
2129:
2125:
2118:Washington Post
2110:
2103:
2064:
2060:
2053:
2039:
2035:
2027:
2023:
2022:
2018:
2008:
2006:
2001:
2000:
1996:
1988:
1984:
1983:
1976:
1966:
1964:
1959:
1958:
1954:
1944:
1942:
1937:
1936:
1932:
1923:
1921:
1917:
1907:
1905:
1900:
1899:
1892:
1882:
1880:
1875:
1874:
1870:
1860:
1858:
1853:
1852:
1848:
1838:
1836:
1831:
1830:
1826:
1816:
1814:
1805:
1804:
1800:
1785:
1781:
1771:
1769:
1764:
1763:
1759:
1749:
1747:
1742:
1741:
1737:
1728:
1727:
1723:
1713:
1711:
1706:
1705:
1701:
1688:
1687:
1683:
1670:
1669:
1662:
1652:
1650:
1645:
1644:
1640:
1630:
1628:
1623:
1622:
1618:
1608:
1606:
1598:
1594:
1593:
1578:
1570:
1566:
1565:
1548:
1538:
1536:
1532:
1528:
1527:
1518:
1508:
1506:
1502:
1498:
1497:
1486:
1449:
1436:
1429:
1415:
1414:
1410:
1397:
1396:
1392:
1385:
1369:
1356:
1349:
1333:
1320:
1313:
1299:
1298:
1291:
1286:
1270:
1260:and refractory
1254:
1231:
1222:
1123:Merck & Co.
1107:
1102:
1093:
1087:
1084:
1063:
1054:
1048:
1045:
1024:
1012:
988:corticosteroids
976:glucocorticoids
972:pituitary gland
968:
956:
954:Adverse effects
936:
916:Crohn's disease
908:glucocorticoids
889:chorioretinitis
849:dermatomyositis
803:
779:corticosteroids
710:
708:
705:(what is this?)
702:
697:
694:
689:
684:
683:
667:
665:
652:
646:
640:
634:
595:
575:
555:
535:
515:
495:
475:
458:
450:
430:
427:
335:
334:
318:
272:
270:
223:
221:
208:
202:
196:
190:
151:
135:
118:
110:
107:
102:
101:
85:
26:
17:
12:
11:
5:
3240:
3230:
3229:
3224:
3219:
3202:
3201:
3199:
3198:
3193:
3188:
3170:
3168:
3164:
3163:
3161:
3160:
3155:
3150:
3145:
3140:
3135:
3130:
3125:
3120:
3115:
3106:
3104:
3100:
3099:
3097:
3096:
3087:
3086:
3081:
3072:
3071:
3066:
3061:
3056:
3054:Modimelanotide
3051:
3046:
3028:
3023:
3018:
3013:
3008:
2999:
2997:
2993:
2988:
2987:
2985:
2984:
2975:
2974:
2969:
2964:
2959:
2954:
2949:
2944:
2939:
2934:
2929:
2924:
2919:
2914:
2909:
2900:
2899:
2894:
2889:
2884:
2879:
2874:
2869:
2867:Modimelanotide
2864:
2859:
2854:
2836:
2831:
2826:
2821:
2816:
2811:
2802:
2800:
2796:
2791:
2790:
2788:
2787:
2782:
2777:
2772:
2767:
2762:
2757:
2752:
2743:
2742:
2737:
2735:Modimelanotide
2732:
2727:
2709:
2704:
2699:
2690:
2688:
2684:
2679:
2678:
2676:
2675:
2670:
2665:
2660:
2655:
2650:
2645:
2640:
2635:
2630:
2621:
2619:
2615:
2610:
2609:
2607:
2606:
2597:
2596:
2591:
2586:
2581:
2576:
2571:
2569:Modimelanotide
2566:
2561:
2543:
2538:
2533:
2528:
2523:
2518:
2509:
2507:
2503:
2498:
2497:
2487:
2486:
2479:
2472:
2464:
2458:
2457:
2447:
2435:
2434:External links
2432:
2429:
2428:
2392:
2360:
2329:
2294:
2243:
2232:
2217:
2205:
2186:
2164:
2142:
2137:New York Times
2123:
2101:
2058:
2051:
2033:
2016:
1994:
1974:
1952:
1930:
1915:
1890:
1868:
1846:
1824:
1798:
1779:
1757:
1735:
1721:
1699:
1696:8-K index page
1681:
1660:
1638:
1616:
1576:
1546:
1516:
1484:
1463:(5): 250–257.
1434:
1427:
1408:
1390:
1383:
1354:
1347:
1318:
1311:
1288:
1287:
1285:
1282:
1269:
1266:
1253:
1250:
1230:
1227:
1221:
1218:
1217:
1216:
1213:
1206:
1205:
1198:
1172:
1171:
1164:
1145:
1138:
1127:
1106:
1105:Approved forms
1103:
1101:
1098:
1095:
1094:
1075:
1073:
1062:
1059:
1056:
1055:
1036:
1034:
1023:
1020:
1011:
1008:
996:adrenal glands
967:
964:
955:
952:
935:
932:
928:osteoarthrosis
885:optic neuritis
861:serum sickness
802:
799:
787:adrenal glands
767:tetracosactrin
759:tetracosactide
748:tropic hormone
717:
716:
699:
698:
696:
695:
692:
690:
687:
679:
678:
677:
674:
673:
663:
657:
656:
650:
644:
638:
632:
627:
621:
620:
616:
615:
605:
597:
596:
594:
593:
585:
583:
577:
576:
574:
573:
565:
563:
557:
556:
554:
553:
545:
543:
537:
536:
534:
533:
525:
523:
517:
516:
514:
513:
505:
503:
497:
496:
494:
493:
485:
483:
477:
476:
474:
473:
465:
463:
452:
451:
449:
448:
440:
438:
432:
431:
429:
428:
366:-phenylalanyl-
338:
330:
329:
328:
325:
324:
320:
319:
317:
316:
303:
301:
295:
294:
287:
277:
276:
267:
263:
262:
259:
253:
252:
248:
247:
236:Tetracosactide
230:
229:
219:
213:
212:
206:
200:
194:
188:
183:
177:
176:
172:
171:
161:
153:
152:
150:
149:
145:
143:
137:
136:
134:
133:
125:
123:
112:
111:
109:
108:
105:
97:
96:
95:
92:
91:
87:
86:
84:
83:
79:
77:
71:
70:
66:
65:
58:
48:
47:
44:
38:
37:
15:
9:
6:
4:
3:
2:
3239:
3228:
3225:
3223:
3220:
3218:
3215:
3214:
3212:
3197:
3194:
3192:
3189:
3186:
3182:
3178:
3175:
3172:
3171:
3169:
3165:
3159:
3156:
3154:
3151:
3149:
3146:
3144:
3141:
3139:
3136:
3134:
3131:
3129:
3126:
3124:
3121:
3119:
3116:
3114:
3111:
3108:
3107:
3105:
3101:
3095:
3092:
3089:
3088:
3085:
3082:
3080:
3077:
3074:
3073:
3070:
3067:
3065:
3062:
3060:
3057:
3055:
3052:
3050:
3047:
3044:
3040:
3036:
3032:
3029:
3027:
3024:
3022:
3019:
3017:
3016:Bremelanotide
3014:
3012:
3009:
3007:
3004:
3001:
3000:
2998:
2996:
2989:
2983:
2980:
2977:
2976:
2973:
2970:
2968:
2965:
2963:
2960:
2958:
2955:
2953:
2950:
2948:
2945:
2943:
2940:
2938:
2935:
2933:
2930:
2928:
2925:
2923:
2920:
2918:
2915:
2913:
2910:
2908:
2905:
2902:
2901:
2898:
2895:
2893:
2892:Setmelanotide
2890:
2888:
2885:
2883:
2880:
2878:
2875:
2873:
2870:
2868:
2865:
2863:
2860:
2858:
2855:
2852:
2848:
2844:
2840:
2837:
2835:
2832:
2830:
2829:Bremelanotide
2827:
2825:
2822:
2820:
2817:
2815:
2812:
2810:
2807:
2804:
2803:
2801:
2799:
2792:
2786:
2783:
2781:
2778:
2776:
2773:
2771:
2768:
2766:
2763:
2761:
2758:
2756:
2753:
2751:
2748:
2745:
2744:
2741:
2738:
2736:
2733:
2731:
2728:
2725:
2721:
2717:
2713:
2710:
2708:
2707:Bremelanotide
2705:
2703:
2700:
2698:
2695:
2692:
2691:
2689:
2687:
2680:
2674:
2671:
2669:
2666:
2664:
2661:
2659:
2656:
2654:
2651:
2649:
2646:
2644:
2641:
2639:
2636:
2634:
2631:
2629:
2626:
2623:
2622:
2620:
2618:
2611:
2605:
2602:
2599:
2598:
2595:
2592:
2590:
2587:
2585:
2582:
2580:
2577:
2575:
2572:
2570:
2567:
2565:
2562:
2559:
2555:
2551:
2547:
2544:
2542:
2539:
2537:
2534:
2532:
2531:Bremelanotide
2529:
2527:
2524:
2522:
2519:
2517:
2514:
2511:
2510:
2508:
2506:
2499:
2495:
2492:
2485:
2480:
2478:
2473:
2471:
2466:
2465:
2462:
2455:
2451:
2448:
2445:
2441:
2438:
2437:
2418:on 2014-12-22
2414:
2410:
2403:
2396:
2381:on 2017-02-02
2377:
2370:
2364:
2348:
2344:
2340:
2333:
2325:
2321:
2317:
2313:
2309:
2305:
2298:
2290:
2286:
2281:
2276:
2271:
2266:
2262:
2258:
2254:
2247:
2236:
2228:
2221:
2214:
2209:
2201:
2197:
2190:
2174:
2168:
2160:
2156:
2149:
2147:
2138:
2134:
2127:
2119:
2115:
2108:
2106:
2097:
2093:
2089:
2085:
2081:
2077:
2073:
2069:
2062:
2054:
2048:
2044:
2037:
2026:
2020:
2004:
1998:
1987:
1981:
1979:
1962:
1956:
1940:
1934:
1926:
1919:
1903:
1897:
1895:
1878:
1872:
1856:
1850:
1834:
1828:
1812:
1808:
1802:
1794:
1790:
1783:
1767:
1761:
1745:
1739:
1731:
1725:
1709:
1703:
1697:
1691:
1685:
1679:
1673:
1667:
1665:
1648:
1642:
1626:
1620:
1604:
1597:
1591:
1589:
1587:
1585:
1583:
1581:
1569:
1563:
1561:
1559:
1557:
1555:
1553:
1551:
1531:
1525:
1523:
1521:
1501:
1495:
1493:
1491:
1489:
1480:
1476:
1471:
1466:
1462:
1458:
1454:
1447:
1445:
1443:
1441:
1439:
1430:
1424:
1420:
1419:
1412:
1404:
1400:
1394:
1386:
1380:
1376:
1375:
1367:
1365:
1363:
1361:
1359:
1350:
1344:
1340:
1339:
1331:
1329:
1327:
1325:
1323:
1314:
1308:
1304:
1303:
1296:
1294:
1289:
1281:
1279:
1275:
1265:
1263:
1259:
1249:
1246:
1240:
1237:
1226:
1214:
1211:
1210:
1209:
1203:
1199:
1196:
1192:
1188:
1184:
1180:
1179:
1178:
1175:
1169:
1165:
1162:
1158:
1154:
1150:
1146:
1143:
1139:
1136:
1132:
1128:
1124:
1120:
1116:
1112:
1111:
1110:
1091:
1082:
1078:
1074:
1071:
1067:
1066:
1052:
1043:
1039:
1035:
1032:
1028:
1027:
1022:Manufacturing
1019:
1017:
1007:
1005:
1004:adrenal gland
1001:
997:
993:
989:
984:
981:
977:
973:
963:
961:
951:
947:
944:
942:
931:
929:
925:
921:
917:
913:
909:
904:
902:
898:
894:
890:
886:
882:
878:
874:
873:iridocyclitis
870:
866:
862:
858:
854:
850:
847:and systemic
846:
842:
838:
834:
830:
826:
821:
818:
816:
812:
808:
798:
796:
795:adrenal gland
792:
788:
784:
780:
776:
772:
768:
764:
760:
755:
753:
749:
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386:-valylglycyl-
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36:Clinical data
34:
24:
19:
3174:Propeptides:
3173:
3158:Tridecactide
3153:Tricosactide
3123:Dersimelagon
3109:
3090:
3076:Antagonists:
3075:
3049:Melanotan II
3002:
2978:
2904:Antagonists:
2903:
2857:Melanotan II
2805:
2747:Antagonists:
2746:
2730:Melanotan II
2693:
2673:Tridecactide
2668:Tricosactide
2624:
2601:Antagonists:
2600:
2564:Melanotan II
2512:
2420:. Retrieved
2413:the original
2408:
2395:
2383:. Retrieved
2376:the original
2363:
2351:. Retrieved
2347:the original
2342:
2332:
2307:
2303:
2297:
2260:
2256:
2246:
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2220:
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2177:. Retrieved
2167:
2159:FiercePharma
2158:
2136:
2126:
2117:
2071:
2067:
2061:
2042:
2036:
2019:
2007:. Retrieved
1997:
1965:. Retrieved
1955:
1943:. Retrieved
1933:
1918:
1906:. Retrieved
1881:. Retrieved
1871:
1859:. Retrieved
1849:
1837:. Retrieved
1827:
1815:. Retrieved
1811:the original
1801:
1792:
1782:
1770:. Retrieved
1760:
1748:. Retrieved
1738:
1732:. SEC Edgar.
1724:
1712:. Retrieved
1702:
1684:
1651:. Retrieved
1641:
1629:. Retrieved
1619:
1607:. Retrieved
1602:
1537:. Retrieved
1507:. Retrieved
1460:
1456:
1417:
1411:
1402:
1393:
1373:
1341:. Springer.
1337:
1301:
1276:to diagnose
1271:
1255:
1245:Mallinckrodt
1241:
1232:
1223:
1207:
1176:
1173:
1168:Mallinckrodt
1108:
1088:January 2017
1085:
1081:adding to it
1076:
1049:January 2017
1046:
1042:adding to it
1037:
1013:
985:
969:
966:Pharmacology
957:
948:
945:
937:
905:
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801:Medical uses
770:
766:
762:
758:
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740:
739:is known as
734:
721:
720:
709:
703:
358:-α-glutamyl-
75:Legal status
69:Legal status
18:
3084:ML-00253764
2952:ML-00253764
2872:PF-00446687
2765:ML-00253764
2450:Cosyntropin
2353:January 23,
2263:: 147–153.
2229:. CBC News.
2179:16 November
1016:amino acids
899:in certain
893:sarcoidosis
881:choroiditis
775:amino acids
771:cosyntropin
745:polypeptide
672: g·mol
608:100.037.286
354:-methionyl-
323:Identifiers
266:Other names
257:Trade names
228: g·mol
164:100.037.286
90:Identifiers
42:Trade names
3211:Categories
3177:Lipotropin
2887:Ro 27-3225
2834:LY-2112688
2526:BMS-470539
2494:modulators
2422:2017-01-23
2385:23 January
2343:dvm360.com
2043:Rough Ride
2009:22 January
1967:22 January
1945:22 January
1908:22 January
1883:22 January
1861:22 January
1839:22 January
1817:23 January
1772:22 January
1750:22 January
1714:22 January
1653:22 January
1631:22 January
1609:28 January
1539:23 January
1509:28 January
1284:References
1006:function.
1002:to assess
813:, via the
797:function.
793:to assess
661:Molar mass
590:CHEBI:3901
550:72YY86EA29
521:ChemSpider
481:IUPHAR/BPS
445:16960-16-0
436:CAS Number
362:-histidyl-
332:IUPAC name
217:Molar mass
141:ChemSpider
99:IUPAC name
3138:Seractide
3128:Giractide
3118:Codactide
3113:Alsactide
3110:Agonists:
3003:Agonists:
2824:BIM-22493
2806:Agonists:
2694:Agonists:
2653:Seractide
2643:Giractide
2638:Codactide
2633:Alsactide
2625:Agonists:
2594:SNAP-7941
2513:Agonists:
1457:P & T
1010:Chemistry
994:from the
865:keratitis
785:from the
763:synacthen
422:-tyrosyl-
402:-arginyl-
398:-arginyl-
370:-arginyl-
346:-tyrosyl-
285:Drugs.com
56:Drugs.com
3103:Unsorted
3091:Unknown:
3069:SHU-9119
3064:SHU-9005
3059:SHU-8914
2979:Unknown:
2972:SHU-9119
2967:SHU-9005
2962:SHU-8914
2947:MCL-0129
2942:MCL-0042
2937:MCL-0020
2785:SHU-9119
2780:SHU-9005
2775:SHU-8914
2589:SHU-9119
2584:SHU-9005
2579:SHU-8914
2324:18537878
2289:21448451
2200:Futurism
2096:28664950
2088:21170520
1479:19561871
1252:Research
1202:Novartis
1195:Novartis
992:cortisol
990:such as
980:cortisol
783:cortisol
781:such as
712:(verify)
530:10481947
501:DrugBank
470:16129617
426:-proline
406:-prolyl-
382:-prolyl-
299:ATC code
269:Ba 30920
130:16132265
2932:JKC-363
2882:PL-6983
2862:MK-0493
2819:AZD2820
2574:PL-8177
2280:3063118
1470:2697107
1229:Pricing
1183:Organon
1161:Actavis
1157:generic
1061:History
877:uveitis
728:in the
625:Formula
510:DB01284
456:PubChem
418:-valyl-
414:-lysyl-
410:-valyl-
394:-lysyl-
390:-lysyl-
378:-lysyl-
350:-seryl-
342:-seryl-
315:)
309: (
307:H01AA02
181:Formula
116:PubChem
3167:Others
3026:HS-024
3021:HS-014
2957:MPB-10
2927:HS-131
2922:HS-024
2917:HS-014
2877:PG-931
2770:PG-106
2760:HS-014
2740:PG-931
2541:HS-024
2536:HS-014
2456:(MeSH)
2446:(MeSH)
2322:
2287:
2277:
2094:
2086:
2049:
1477:
1467:
1425:
1381:
1345:
1309:
1220:Doping
1153:Solvay
1149:Abbvie
1142:Sanofi
1135:Pfizer
869:iritis
859:; for
570:D00284
3094:Semax
2982:Semax
2416:(PDF)
2405:(PDF)
2379:(PDF)
2372:(PDF)
2092:S2CID
2028:(PDF)
2005:. FDA
1989:(PDF)
1963:. FDA
1941:. FDA
1904:. FDA
1879:. FDA
1857:. FDA
1835:. FDA
1768:. FDA
1746:. FDA
1710:. FDA
1649:. FDA
1627:. FDA
1505:. FDA
1503:(PDF)
1399:"BNF"
1191:Mylan
926:, or
897:edema
681:InChI
581:ChEBI
3079:ASIP
2912:ASIP
2907:AGRP
2897:THIQ
2755:ASIP
2750:AGRP
2604:ASIP
2387:2017
2355:2017
2320:PMID
2285:PMID
2181:2015
2084:PMID
2047:ISBN
2011:2017
1969:2017
1947:2017
1910:2017
1885:2017
1863:2017
1841:2017
1819:2017
1774:2017
1752:2017
1716:2017
1694:See
1676:See
1655:2017
1633:2017
1611:2021
1541:2017
1511:2021
1475:PMID
1423:ISBN
1403:NICE
1379:ISBN
1343:ISBN
1307:ISBN
871:and
855:and
839:and
835:and
769:and
561:KEGG
541:UNII
490:6965
281:AHFS
148:none
52:AHFS
3031:MSH
2839:MSH
2712:MSH
2546:MSH
2312:doi
2275:PMC
2265:doi
2076:doi
2072:399
1465:PMC
1119:gel
1083:.
1044:.
670:.49
668:933
639:210
633:136
460:CID
312:WHO
226:.14
224:541
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189:207
120:CID
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2992:MC
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