Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- See Monitoring requirements below
 
- Also licensed via intramuscular route
 
      
  
        Available preparations
  
                  Synacthen 250 microgram in 1ml ampoule
      
  
        Reconstitution
  
                  Already in solution
Draw up using a 5 micron filter needle
      
  
        Methods of intravenous administration
  
                  Slow intravenous injection - see also Further information
- Administer over at least three minutes (ref 1)
 
- May be further diluted to a convenient volume with sodium chloride 0.9% to aid administration(ref 1)
 
      
  
        Dose in adults
  
                  Diagnostic test for adrenal insufficiency
- Give 250 micrograms
 
- Measure plasma cortisol levels immediately before and thirty minutes after administration of the tetracosactride
 
- Adrenocorticol function can be considered normal if the post-injection rise in plasma cortisol concentration amounts to at least 200nmol/L (70mcg/L)
 
      
  
        Monitoring
  
                  
- Ensure resuscitation facilities are available, should a serious hypersensivity reaction occur
 
- Patients should be kept under observation for 60 minutes after the injection due to the possibility of hypersensitivity reactions
 
      
  
        Further information
  
                  
- The drug may also be given by intramuscular injection (at the same dose)
 
      
  
        Storage
  
                  Store between 2 and 80C
      
  
        References
  
                  SPC March 2022
(1) Injectable Medicines Administration Guide, downloaded from Medusa 21/01/2025
      
  
        Therapeutic classification
  
                  Diagnostic agent