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Infants and Epilepsy Title
* General Introduction
* Causes
* Specific Seizure Syndromes
* Evaluation
* Treatment Options
* Outcome
Two Hands

Medicine Identification Chart

H.P. Acthar Gel

Generic name: repository corticotropin injection- ACTH

Manufacturer: Questcor Pharmaceuticals

Uses: Treatment of Infantile spasms. ACTH has been used since the late 1950s to treat infantile spasms. This use has been submitted to the U.S. Food and Drug Administration for approval.

How it works: It is not understood why or how ACTH works to control the infantile spasms.

How given: ACTH is given by intramuscular injections. Parents and/or caregivers are taught how to do this by medical/nursing personnel. It requires a prescription for both the ACTH and the equipment (such as syringes and needles). Dosing amounts and schedules will be determined by the prescribing physician.

Duration: Unlike other medications, ACTH is used only temporarily for periods ranging from 2 – 12 weeks, depending upon the seizure response.

Side Effects: Most children will gain weight and retain extra fluid during the time they receive ACTH. This weight may present as facial puffiness. The weight will disappear once the ACTH stops. Irritability with increased crying and decreased sleeping are common side effects. High blood pressure, heart failure, calcifications of kidney and pancreas, increased risk of infections, increased blood glucose and increased appetite are other possible side effects. Children receiving ACTH should have blood pressure, weight and serum electrolytes monitored frequently during the time they are receiving the ACTH.

Care during ACTH treatment: Do not receive vaccinations. Avoid exposure to those who have recently received polio vaccine. Avoid known exposure to varicella (chickenpox) and measles. If exposed, contact your treating physician. If surgery is required during the period of ACTH therapy or within the first 12 months after stopping treatment, be sure to let your physician (surgeon) know as supplementation with a steroid may be required at the time of the surgery.

Possible drug interactions: some heart medicines, acetazolamide, amphotericin B, nonsteroidal antiinflammatory drugs (e.g. ibuprofen), aspirin, barbiturate preparations, growth hormone, phenytoin, potassium salts, rifampin and water pills.

Possible Contraindications to Use of ACTH:

  • Diabetes
  • Acute or chronic bacterial or fungal infections
  • High blood pressure
  • Heart failure
  • Renal failure with fluid retention

Not everyone experiences side effects. There may be other side effects than those listed above. For a complete list, consult your doctor, nurse or pharmacist. More detailed sources of information on side effects include the drug’ s prescribing information sheet, the Physician’ s Desk Reference and the pharmaceutical company which produces the drug.