Dosing and Administration

Acthar is a highly purified sterile preparation of the adrenocorticotropic hormone in 16% gelatin to provide a prolonged release after subcutaneous or intramuscular injection. Acthar is available as a 5-mL multi-dose vial containing 80 U/mL (400 U/5-mL vial).

  • The usual dose of Acthar is 40 to 80 units given subcutaneously or intramuscularly every 24 to 72 hours1
  • Based on clinical experience from a retrospective case series of 5 patients with dermatomyositis and polymyositis, 4 patients received 80 units (1 mL) 2x/week for 12 weeks, and 1 patient received 80 units 1x/week for 12 weeks2

Dosing considerations

  • Dosage should be individualized according to the general medical condition of each patient
  • Frequency and dose of the drug should be determined by considering severity of the disease and the initial response of the patient

Acthar offers flexible dosing for your patients1

  • Acthar is a self-administered subcutaneous or intramuscular injection, which gives patients the flexibility to take it at home or wherever it is best for them

Please see Important Safety Information below. For a full list of indications, contraindications, warnings, precautions, and adverse events related to Acthar, please refer to the full Prescribing Information.

SC Injection Training Video

Step-by-step instructions on how to inject Acthar subcutaneously.

Step-by-step instructions on how to inject Acthar subcutaneously.1:22

Watch Spanish version.

IM Injection Training Video

Step-by-step instructions on how to inject Acthar intramuscularly.

Step-by-step instructions on how to inject Acthar subcutaneously.1:19

Watch Spanish version.

Dosing and administration support from Mallinckrodt

As part of our commitment to patients with dermatomyositis and polymyositis, Mallinckrodt provides a variety of home injection training and treatment support services:

  • Self-administration educational materials, including downloadable instructions and online videos for you to use with your staff and for patient training (visit the Resource Library)
  • The Acthar patient site offers home injection instructions to help patients learn on their own time
  • An Acthar Rheumatology Starter Kit is available through an Acthar Specialty Sales Consultant
  • Injection Training—Patients or their care partners may request a home visit, online session, or phone call with a licensed nurse to provide one-on-one injection training for Acthar


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  • Acthar should never be administered intravenously
  • Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of Acthar
  • Acthar is contraindicated where congenital infections are suspected in infants
  • Acthar is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history of or the presence of a peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency, adrenocortical hyperfunction or sensitivity to proteins of porcine origins


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H.P. Acthar® Gel (repository corticotropin injection) is an adrenocorticotropic hormone (ACTH) analogue used for:

  • Treatment during an exacerbation or as maintenance therapy in selected cases of systemic dermatomyositis (polymyositis)
  • Treatment during an exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus
  • The treatment of symptomatic sarcoidosis
  • Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy)