Acthar Gel (Repository Corticotropin Injection) for Multiple Sclerosis

Acthar Gel (repository corticotropin injection) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with flare-ups (sudden worsening of symptoms) of multiple sclerosis (MS).

How Acthar Gel Works and How It’s Taken

Acthar Gel is a type of adrenocorticotropic hormone medicine. The hormone stimulates the adrenal glands to release natural steroid hormones to help treat acute MS flare-ups.

In adults with multiple sclerosis flare-ups, Acthar Gel has been shown to help recovery and speed the improvement of acute attacks, although its exact action is not fully known.

Doctors prescribe Acthar Gel when an adult is having a sudden worsening of MS symptoms.

Acthar Gel is given as an injection into the muscle or under the skin, typically once daily for two to three weeks. With proper training, injections may be given at home.

Typical Dosing for Multiple Sclerosis

The recommended dose of Acthar Gel for multiple sclerosis flare-ups is 80 to 120 units daily as an injection into the muscle or under the skin, for two to three weeks.

Your doctor may slowly lower the dose or give the shots less often before stopping treatment. Do not stop treatment suddenly unless your healthcare provider tells you to.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Acthar Gel Side Effects

The prescribing information does not list exact rates for side effects when Acthar Gel is used for multiple sclerosis flare-ups because they are not known from the study data. Common side effects are based on people’s real-world experience using Acthar Gel.

Common side effects include:

Reactions at the injection site
Tiredness or weakness
Fluid buildup and swelling
Trouble sleeping
Headache
Higher blood sugar levels

Serious Side Effects and Warnings

Acthar Gel can cause serious side effects that require immediate medical attention. These include:

Serious infections — Acthar Gel may raise the risk of infections, including viral, bacterial, fungal, protozoan, or parasitic infections.
Cushing’s syndrome and adrenal insufficiency after stopping treatment — This includes high cortisol during treatment and low cortisol after treatment.
Increased blood pressure, fluid retention, and low potassium — Blood pressure may rise, and the body may hold on to salt and water.
Gastrointestinal bleeding, ulcers, or perforation — This includes serious stomach or intestinal bleeding, sores, or a hole in the stomach or intestine.
Behavioral and mood changes — These may include insomnia, mood swings, severe depression, or psychosis.
Eye problems — Cataracts, glaucoma, or eye infections can affect vision.
Severe allergic reactions, including anaphylaxis — This can include hives, swelling, trouble breathing, low blood pressure, or shock.
Bone loss — Decreased bone density can raise the risk of fractures.

Get medical help right away if you think you are having a serious reaction.

How To Save on Acthar Gel

Mallinckrodt Pharmaceuticals, the manufacturer of Acthar Gel, offers the Acthar Gel Commercial Co-pay Program. Eligible people with commercial or private insurance may pay as little as $0.

If you do not have insurance coverage, you may be able to receive financial support through the Acthar Patient Assistance Program.

To learn more, visit the Acthar Gel Assistance Options page or call 877-503-7746.

What To Know Before Taking Acthar Gel

Tell your doctor if you have any allergies to a repository corticotropin injection or any ingredients in Acthar Gel, or if you are sensitive to pig-derived proteins.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

If you have any of the following conditions, do not take Acthar Gel until you have talked to your doctor:

A skin condition called scleroderma
Bone density loss or osteoporosis
Any infections, including fungal, bacterial, or viral
Eye infections, such as ocular herpes simplex
Stomach ulcers or a history of stomach ulcers
Heart failure
Uncontrolled high blood pressure
Addison’s disease or Cushing’s syndrome
Allergies to pig-derived proteins

Also let your doctor know if you have recently had surgery or if you have been given or are about to receive a live or live attenuated vaccine.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Acthar Gel, talk with your doctor about the risks and benefits. Acthar Gel may cause fetal harm when used during pregnancy.

Acthar Gel is also FDA approved to treat infantile spasms (in children under 2 years of age), certain rheumatic disorders, certain collagen diseases, certain skin diseases, allergic states, certain eye diseases, certain respiratory diseases, and an edematous state.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Acthar Gel?
Controlled clinical trials have shown Acthar Gel is effective in speeding the resolution of acute flares of multiple sclerosis. The prescribing information does not give exact response rates for using Acthar Gel. There is no evidence that Acthar Gel can cure or slow the course of MS itself.

Can I take Acthar Gel if I have an infection?
Acthar Gel can affect your body’s ability to fight infections. If you have an infection, talk to your healthcare provider before using this medicine. They will decide if it is safe for you and monitor you closely during treatment.

What tests or monitoring are needed with Acthar Gel for multiple sclerosis?
While using Acthar Gel, your healthcare provider will check for side effects and safety. This may include watching for signs of infection, checking your blood pressure, and testing your blood sugar. They may also look for swelling, changes in mood, or problems with body salts. When stopping treatment, they may watch for signs that your body is not making enough natural steroids.

How long does Acthar Gel take to work for multiple sclerosis?
It is not known exactly how fast Acthar Gel starts to work for multiple sclerosis flare-ups. The prescribing information says it can help speed up recovery from an attack in adults, but it does not give a specific timeline.