Contraindications
In the US the only contraindication for tetracosactide for diagnostic use is hypersensitivity to ACTH but in the UK, regulators placed contraindications for hypersensitivity to ACTH and additionally, for people with allergic disorders including asthma, acute psychosis, infectious diseases, peptic ulcer, refractory heart failure, Cushings syndrome, treatment of primary adrenocortical insufficiency and adrenocongenital syndrome.The same contraindications that were applied in the UK for diagnostic use of tetracosactide, apply for therapeutic use of both tetracosactide and corticotropin in the US and UK.In addition, the US label for corticotropin for therapeutic uses includes contraindications for people who have recently had surgery, and people with scleroderma, osteoporosis, uncontrolled hypertension, or sensitivity to proteins of porcine origin; in addition the infection diseases systemic fungal infection, ocular herpes simplex, and infants who have congenital infections are specified. The label also notes that people taking corticotropin for immunosuppression should not be given live vaccines. Adverse effects
People taking corticotropin or tetracosactide are more likely to get infections, and are at risk of hypothalamic-pituitary-axis (HPA) suppression and Cushings syndrome. Pharmacology
In the normal situation, ACTH is released from the pituitary gland at the base of the brain. It acts on the adrenal glands to stimulate the production of steroid hormones (glucocorticoids). If the adrenal glands are healthy, a single injection of tetracosactide results in a rise in blood cortisol concentrations in 30 minutes.
Adrenocorticotropic hormone is used as a medication and as diagnostic agent in the ACTH stimulation test. : 316, 1165 : 84, 271 The form that is purified from pig pituitary glands is known as corticotropin: 316  is a medication and naturally occurring polypeptide tropic hormone produced and secreted by the anterior pituitary gland. : 84 The form that is made synthetically is tetracosactide, also known as synacthen, tetracosactrin and cosyntropin. : 1165 : 271  It consists of the first 24 (of a total of 39) amino acids of ACTH and retains full function of the parent peptide. : 1165   Tetracosactide stimulates the release of corticosteroids such as cortisol from the adrenal glands, and is used for the ACTH stimulation test to assess adrenal gland function. : 271

Medical uses
Both corticotropin and tetracosactide have been used for diagnostic purposes to determine adrenocortical insufficiency, particularly in Addisons disease, via the ACTH stimulation test. However, as of 2015 the US label for corticotropin does not include diagnostic use.Both corticotropin and tetracosactide have been used for therapeutic purposes.