Stimulates adrenal cortex to release cortisol, aldosterone, and weak androgens

Binds to melanocortin receptors

May suppress endogenous ACTH release via feedback

• Infantile Spasms (monotherapy for children <2 years)

  • IM only, not via prefilled SelfJect.

• Multiple Sclerosis (MS) (acute exacerbations in adults)

  • IM or SC; 80–120 units daily for 2–3 weeks.

• Other approved uses (as adjunct or short-term therapy):

  • Rheumatic disorders (RA, psoriatic arthritis)

  • Collagen diseases (lupus, dermatomyositis)

  • Dermatologic (erythema multiforme, Stevens-Johnson)

  • Allergic states (serum sickness)

  • Ophthalmic diseases (uveitis, optic neuritis)

  • Respiratory (sarcoidosis)

  • Edematous states (nephrotic syndrome without uremia)

• Infantile Spasms: 150 U/m²/day IM (75 U/m² BID) for 2 weeks, then taper over 2 weeks.
• MS exacerbations: 80–120 units daily (IM or SC) for 2–3 weeks, taper if needed.
• Other indications: 40–80 units IM/SC every 24–72 hours, individualized.

SelfJect Injectors:

• 40 Units (Green): for 40-unit SC doses only.
• 80 Units (Purple): for 80-unit SC doses only.
• Not suitable for infantile spasms.

In Infants (<2 years with infantile spasms):

• Infection (20–46%)
• Convulsions, irritability, hypertension, pyrexia
• GI issues (vomiting, diarrhea)
• Cushingoid symptoms, weight gain

IV use

Infants <2 years with suspected congenital infections

Patients with: scleroderma, systemic fungal infections, CHF, uncontrolled hypertension, porcine protein allergy

Infection risk: Immunosuppressive; may worsen or reactivate latent infections.

Adrenal suppression and Cushing's syndrome

Hypertension, fluid retention, hypokalemia

GI perforation/ulcers, especially with underlying GI disorders

Behavioral/mood changes, including euphoria, depression, psychosis

Eye effects: Cataracts, glaucoma, secondary infections

Growth suppression in children

Bone density loss and osteoporosis risk