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Learn how to take Acthar Gel

As soon as you are prescribed Acthar Gel, contact your Nurse Navigator to coordinate free one-on-one injection training. There are resources below to supplement your one-on-one injection training.

Your doctor will determine how much and how often you should take Acthar Gel.

Did you know?

You can take Acthar Gel at home

You can take Acthar Gel wherever you and your doctor decide is best for you. You can inject the treatment yourself, or get assistance from a family member, friend, caregiver, or a doctor can help you.

Acthar Gel can be injected in 2 ways*:

  • Subcutaneously (a short needle under the skin)
  • Intramuscularly (into a muscle)

*Acthar Gel should never be taken intravenously (into a vein) or by mouth.
Your doctor will tell you how much Acthar Gel you should take, and where on the body you should inject.

Download resources below to supplement your in-person injection training.

Injection Training Guide

Download a guide to help you with
treatment by walking you through
the steps of the injection process.

For caregivers of IS patients click here.

Free, one-on-one injection training is available to you.

Free injection training, based on your level of need, will help prepare you to be ready to start your therapy when Acthar Gel is delivered.

Learn More
Acthar Gel patient writing in treatment journal

Treatment journal

Stay on track of your treatment journey

In the Acthar Gel treatment journal, you can log your treatment schedule, keep track of appointments, and store contact information for your care team.

GET A TREATMENT JOURNAL GET ADDITIONAL CALENDAR PAGES

Once you receive Acthar Gel

Things to note

Check the vial to make sure that the label states it is Acthar® Gel (repository corticotropin injection).

Check the expiration date on the Acthar Gel vial to make sure you are using it before the date listed.

Refrigerate Acthar Gel as soon as you receive it and check that your refrigerator temperature is currently 36°F—46°F or 2°C—8°C.

  • Unopened vials that are refrigerated (36°F–46°F or 2°C–8°C) are good until the last day of the month listed for expiration on the vial. For example, if your vial's expiration date is 10/2022, it should be discarded on October 31, 2022.

Prior to each use, check for any signs of contamination (cloudiness, small flecks, etc).

DO NOT USE IF:

  • The vial is expired
  • Any signs of contamination are seen

Read the entire instruction guide before you begin your first injection and as needed prior to any injection.

After a vial has been opened (the top seal has been punctured by a needle), it should be discarded after 28 days. For example, if the date you purchased your vial was 10/1/2022, you would need to dispose of that vial 10/29/2022.

Find out how a Nurse Navigator can help coordinate free, one-on-one injection training.
Learn More

Injecting Acthar Gel

Different steps for different conditions

Acthar Gel is prescribed differently for babies with infantile spasms.

If you are treating your baby for infantile spasms, click here for information on Acthar Gel treatment for infantile spasms.

If you are not caring for a baby with infantile spasms, click here to get injection information for your condition.

Acthar Gel Nurse Navigator smiling

Meet Your Nurse Navigator

Free, one-on-one injection training

Learning how to take or give Acthar Gel is personal. That’s why Acthar Patient Support offers free, one-on-one injection training that’s based on your level of need.

While your prescription is in the approval process, your personal Nurse Navigator will contact you to discuss your training needs and how best to accomplish them—in your home, online, or by phone. Then we will coordinate training with a nurse educator to help you get started.

Your nurse educator will:

  • Review the materials needed, including needles, syringes, alcohol wipes, etc
  • Show you or your care partner how and where to inject Acthar Gel
  • Explain how to store Acthar Gel and dispose of used needles and syringes
  • Answer any questions about how to inject Acthar Gel
  • Come back to make sure your injections are going well. The nurse will come to visit you in person or virtually so that you have full confidence in taking Acthar Gel

Help with injections

Dose conversion chart

Keep in mind when taking Acthar Gel:

  • It’s important to take Acthar Gel exactly as directed by your doctor
  • Do not stop taking Acthar Gel without first talking with your doctor
  • Your doctor may change your dose or tell you to stop taking Acthar Gel if needed
  • If you miss a dose of Acthar Gel, call your doctor

This chart can help you remember how much medicine to draw up into the syringe

Prescribed units Injection amount (mL)
80 units 1 mL
60 units 0.75 mL
40 units 0.5 mL
20 units 0.25 mL

Values shown are not all of the possible dosages of Acthar Gel. Dosage and frequency may vary. Your doctor has determined the best dose for you based on your medical history and condition.

Step-by-Step Injection Training Video

See how to inject Acthar Gel (for adult patients only)

Select video:

  1. Welcome to Acthar Gel
  2. Injecting Acthar Gel: Introduction
  3. Getting started with Acthar Gel
  4. Preparing to inject
  5. Where to inject subcutaneously
  6. Subcutaneous injection instructions
  7. Post-injection instructions
  8. About Acthar Patient Support
  9. Indications and Important Safety Information
  10. Where to inject intramuscularly
  11. Intramuscular injection instructions

Spanish version

Select video:

  1. Bienvenido a Acthar
  2. Introducción a la inyección de Acthar
  3. Empezando con Acthar
  4. Preparándose para inyectar
  5. Donde inyectarse por manera subcutánea
  6. Instrucciones de inyección subcutánea
  7. Instrucciones posteriores de la inyección
  8. Sobre el soporte a los pacientes de Acthar
  9. Las Indicaciones y la Información Importante de la Seguridad
  10. Donde inyectar por manera intramuscular
  11. Instrucciones para inyectarse de manera intramuscular

For Infantile Spasms

See how to treat your baby with Acthar Gel

Select chapter:

Injecting at Home

  1. Getting Ready
  2. Preparing the Materials
  3. Preparing the Injection
  4. The Injection
  5. After the Injection

Important Safety Information

Tips for Treating Infantile Spasms

Tips for injecting Acthar Gel for your baby

It can be difficult to think about giving your baby an injection. Remember that by injecting treatment, you may help your baby get well.

These tips may help you feel more confident about injecting Acthar Gel treatment for your baby.

Carefully warm Acthar Gel

Acthar Gel should be stored in the refrigerator between 36°F and 46°F or 2°C and 8°C. Before each injection, warm the vial to room temperature between your hands or under an arm.

Stay calm

If you’re feeling anxious or stressed, your child may reflect the same feelings. Remember that each injection only takes a moment and is important to your child’s health.

Distract the baby

You might squeeze your child’s hand, sing songs, or blow on your baby’s face. There is no limit to distractions you can use—try one whenever you need to.

Use a little sugar

If your doctor says it’s okay, try giving your child a little sugar water before the injection, or dipping a pacifier into sugar water for him or her to suck on during the injection.

Team up and cuddle

If possible, you might give the injection while another caregiver holds or comforts your child. This close contact may help your baby stay calm.

Gently rub the skin

When you lightly rub the injection site after giving a shot, it can feel like a light massage and help the injection seem less painful.

Create a schedule

Plan injections during times when you and your child are mostly likely to be at home. You may feel more at ease in a familiar location.

Pick a spot

Choose a location in your home to perform your child’s injections. Your baby will come to expect a shot in that place and will know the shot is over when you leave.

Update your child’s doctor

Your child’s doctor is your partner throughout your child’s Acthar Gel treatment. Share your baby’s progress and don’t be afraid to ask questions if you’re unsure about anything.

Find out how a Nurse Navigator can help coordinate free, one-on-one injection training.
Acthar Gel travel tips: man walking with luggage

Tips for traveling

Preparing to travel with Acthar Gel

Plan for delays

If you’ll be traveling, make sure you take enough medication with you in case of travel delays.

Keep Acthar Gel refrigerated

Acthar Gel should be kept refrigerated between 36°F and 46°F or 2°C and 8°C between uses. Acthar Gel is a gel when refrigerated, but changes to liquid form at room temperature. Remember to only inject Acthar Gel once it has reached room temperature; this will help make the injection more comfortable for you. Warm Acthar Gel by rolling the vial between the palms of your hands or by holding it under your arm for a few minutes.

Consider getting a cooler

Medical coolers are available for purchase. These items come in different sizes and price ranges. Also, it may help to keep an extra ice pack handy in case one gets lost or damaged.

For road trips

When traveling by car, keep Acthar Gel with you in the car. Avoid storing it in areas where it may get heated. Don’t place Acthar Gel in the glove compartment, trunk, or on the front or rear shelf. Make sure not to leave it in the car unattended on a hot day.

For flights

If you are traveling by air, always pack your medical supplies and Acthar Gel in your carry-on luggage. This way these items are with you at all times, even if your luggage gets lost or damaged.

  • Call your airline in advance to ask if arrangements can be made to keep your medicine in a refrigerator during the flight
  • Contact the Transportation Security Administration (TSA) at least 72 hours before your flight. If you have a medical condition, they can help you coordinate the security screening process in advance. Their toll-free helpline is 1-855-787-22271-855-787-2227, or you can visit them online here
Acthar Gel patient: Gary smiling

Be your own best advocate

If you need additional support

Call Acthar Patient Support at 1-888-435-22841-888-435-2284
Monday through Friday, 8 AM to 9 PM ET
Saturday, 9 AM to 2 PM ET

Please note that Nurse Navigators are not available on Saturdays.

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What is Acthar Gel?

Acthar® Gel is a prescription medicine used for:

  • Reduction of proteinuria in people with nephrotic syndrome of the idiopathic type (unknown origin) without uremia (accumulation of urea in the blood due to malfunctioning kidneys) or that due to lupus erythematosus (lupus)
  • Treatment of infantile spasms in infants and children under 2 years of age
  • Treatment for adults with acute relapses or flares of multiple sclerosis (MS). Studies have shown Acthar to be effective in speeding recovery from an MS relapse. However, there is no evidence that it affects the ultimate outcome or natural history of the disease

IMPORTANT SAFETY INFORMATION

DO NOT take Acthar until you have talked to your doctor if you have any of the following conditions:

  • Have been given or are about to receive a live or live attenuated vaccine
  • A skin condition called scleroderma
  • Bone density loss or osteoporosis
  • Any infections, including fungal, bacterial, or viral

What is Acthar Gel?

Acthar® Gel is a prescription medicine used for:

  • Reduction of proteinuria in people with nephrotic syndrome of the idiopathic type (unknown origin) without uremia (accumulation of urea in the blood due to malfunctioning kidneys) or that due to lupus erythematosus (lupus)
  • Treatment of infantile spasms in infants and children under 2 years of age
  • Treatment for adults with acute relapses or flares of multiple sclerosis (MS). Studies have shown Acthar to be effective in speeding recovery from an MS relapse. However, there is no evidence that it affects the ultimate outcome or natural history of the disease
  • Treatment of severe acute and chronic allergic and inflammatory conditions affecting different parts of the eye. This can include the front part of the eye such as the cornea and iris, or the back part of the eye such as the optic nerve and retina
  • Treatment for people with symptoms of sarcoidosis
  • Treatment for flares or on a regular basis (maintenance) in people with systemic lupus erythematosus (lupus)
  • Treatment for flares or on a regular basis (maintenance) in people with dermatomyositis or polymyositis (DM-PM)
  • Add-on therapy for short-term administration (to tide patients over an acute episode or exacerbation) in: psoriatic arthritis (PsA); rheumatoid arthritis (RA), including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy); ankylosing spondylitis

Acthar is injected beneath the skin or into the muscle.

IMPORTANT SAFETY INFORMATION

DO NOT take Acthar until you have talked to your doctor if you have any of the following conditions:

  • Have been given or are about to receive a live or live attenuated vaccine
  • A skin condition called scleroderma
  • Bone density loss or osteoporosis
  • Any infections, including fungal, bacterial, or viral
  • Eye infections, such as ocular herpes simplex
  • Had recent surgery
  • 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
  • Suspected infections at birth (in infants under 2 years of age)

Tell your doctor about any other health problems that you have. Give your doctor a complete list of medicines you are taking, including all prescription and nonprescription medicines, vitamins, and herbal supplements.

What is the most important information I should know about Acthar?

  • Never inject Acthar directly into a vein
  • Always inject Acthar beneath the skin or into the muscle
  • Follow your doctor’s instructions for injecting Acthar
  • Never stop treatment suddenly unless your doctor tells you to do so
  • Try not to miss any scheduled doctor’s appointments. It is important for the doctor to monitor you while taking Acthar
  • You may be more likely to get new infections. Also, old infections may become active. Tell your doctor if you see any signs of an infection. Contact your doctor at the first sign of an infection or fever. Signs of infection are fever, cough, vomiting, or diarrhea. Other signs may be flu or any open cuts or sores
  • When taking Acthar long-term, your adrenal gland may produce too much of a hormone called cortisol. This can result in symptoms of Cushing’s syndrome. This may cause increased upper body fat, a rounded “moon” face, bruising easily, or muscle weakness
  • Sometimes when you stop taking Acthar long-term, your body may not produce enough natural cortisol. This is called “adrenal insufficiency.” Your doctor may prescribe a steroid medicine to protect you until the adrenal gland recovers
  • You might develop high blood pressure, retain too much salt and water, or have low blood potassium levels. As a result of this, your doctor may recommend some changes to your diet, such as eating less salt or taking certain supplements
  • Vaccines may not work well when you are on Acthar. Talk to your doctor about which vaccines are safe to use when you are taking Acthar
  • Acthar may hide symptoms of other diseases. This can make it more difficult for your doctor to make a diagnosis if something else is going on
  • Stomach or intestinal problems. Acthar may increase the risk of bleeding and stomach ulcers. Tell your doctor if you have stomach pains, bloody vomit, bloody or black stools, excessive tiredness, increased thirst, difficulty breathing, or increased heart rate
  • Taking Acthar can make you feel irritable or depressed. You may also have mood swings or trouble sleeping. These effects are reversible once Acthar therapy is stopped
  • If you have other conditions, such as diabetes or muscle weakness, you may find they get worse
  • You might develop certain eye conditions, such as cataracts, glaucoma, or optic nerve damage
  • Your body may develop allergies to Acthar. Signs of allergic reaction are:
    • Skin rash and itching
    • Swelling of the face, tongue, lips, or throat
    • Trouble breathing
  • The effects of Acthar may be intensified if you have an underactive thyroid or cirrhosis of the liver
  • Long-term Acthar use can affect growth and physical development in children. This can be reversed when Acthar is no longer needed
  • Acthar may cause osteoporosis (weak bones)
  • Acthar might harm an unborn baby. Therefore, tell your doctor if you are pregnant or plan to become pregnant

What are the most common side effects of Acthar?

Commonly reported side effects of Acthar include:

  • Injection site reaction
  • Fatigue, physical weakness, and lack of energy
  • Fluid retention
  • Insomnia (difficulty sleeping)
  • Headache
  • High blood sugar

The most common side effects for the treatment of infantile spasms (IS) are:

  • Increased risk of infections
  • Convulsions
  • High blood pressure
  • Irritability
  • Fever

The above side effects may also be seen in adults and children over 2 years of age. Some children with IS progress to other forms of seizures; IS sometimes masks these seizures, which may become visible after treatment for IS has been completed.

These are not all of the possible side effects of Acthar.

Tell your doctor about any side effect that bothers you, or that does not go away. Call your doctor or pharmacist for medical advice about side effects. You may report side effects to the FDA. Call 1-800-FDA-1088 1-800-FDA-1088 or visit www.fda.gov/medwatch. You may also report side effects by calling 1-800-844-2830 1-800-844-2830.

Please see full Prescribing Information for additional Important Safety Information.

For parents and caregivers of patients with Infantile Spasms, please click here for Important Safety Information.