Purified Cortrophin Gel for multiple sclerosis
Last updated Nov. 11, 2025, by Marisa Wexler, MS
Fact-checked by Inês Martins, PhD
What is Cortrophin Gel for MS?
Purified Cortrophin Gel (repository corticotropin injection) is an injectable therapy approved to treat acute relapses in people with multiple sclerosis (MS).
Marketed by ANI Pharmaceuticals, the medication can be injected subcutaneously, or under-the-skin, or intramuscularly, meaning directly into the muscle.
Cortrophin Gel contains a mixture of the adrenocorticotropic hormone (ACTH), ACTH-related proteins, and other proteins naturally made by the brain’s pituitary gland. ACTH is a naturally occurring signaling molecule that prompts the body to make cortisol, a hormone with powerful anti-inflammatory and immunosuppressive properties.
Although Cortrophin Gel’s mechanism of action isn’t completely understood, it is thought to help dampen the inflammatory immune attacks that drive acute relapses in MS.
Cortrophin Gel serves as an alternative to corticosteroids, which are the standard first-line therapy for speeding recovery from relapses. It can help reduce the duration and severity of the neurological symptoms experienced during a relapse, though it does not alter the overall progression of MS.
In addition to MS, Cortrophin Gel is approved for numerous other autoimmune and inflammatory disorders, including rheumatoid arthritis, sarcoidosis, and systemic lupus erythematosus.
Therapy snapshot
| Brand name: | Purified Cortrophin Gel |
| Chemical name: | Repository corticotropin injection |
| Usage: | Used to speed recovery and ease symptoms during acute MS attacks |
| Administration: | Intramuscular or subcutaneous injection |
Who with MS can take Cortrophin Gel?
Cortrophin Gel is approved in the U.S to treat acute exacerbations of MS.
The therapy is available through a network of specialty pharmacies and distributors in the U.S. To access it, patients and their providers must fill out and submit the Cortrophin Gel Enrollment Form with their prescription.
Cortrophin Gel is contraindicated for people with:
- scleroderma (a condition characterized by hard, thickened skin)
- osteoporosis (low bone density)
- systemic fungal infections
- ocular herpes simplex (an eye infection)
- recent surgery
- history or presence of stomach ulcers
- congestive heart failure
- high blood pressure
- sensitivity to proteins derived from porcine (pig) sources
- abnormal function of the adrenal gland, which produces cortisol
How is Cortrophin Gel administered in MS?
Cortrophin Gel may be administered intramuscularly or subcutaneously, and injections can be given by patients or caregivers after adequate training from a healthcare provider.
The therapy is available as single-dose prefilled syringes for subcutaneous use, as well as multidose vials for subcutaneous or intramuscular use. Recommended injection sites are the abdomen, upper thigh, or upper arm.
For the treatment of acute MS relapses, the recommended dosing regimen is 80-120 units, given daily for two to three weeks. Dosing is typically tailored based on a person’s disease severity and response to treatment.
Cortrophin Gel in clinical trials
Cortrophin Gel was first approved by the U.S. Food and Drug Administration in the 1970s to treat MS relapses, based on early clinical studies showing it could speed recovery compared with a placebo.
In one such trial, conducted in the early 1960s, patients received either Cortrophin Gel or a placebo alongside physical therapy for three weeks. After that period, 50% of those who were treated with Cortrophin showed clear improvement, compared with 22% of participants in the placebo group, a significant difference.
More recently, ANI Pharmaceuticals tested a newer version of Cortrophin Gel in a small clinical trial involving 20 healthy volunteers. This version gained a new approval for the treatment of MS relapses in 2021, prompting Cortrophin Gel’s relaunch for MS.
Data showed the new version was comparable to the original in terms of safety and its effects on cortisol levels.
Cortrophin Gel side effects
Common side effects of Cortrophin Gel include:
- muscle weakness
- osteoporosis and fractures
- stomach ulcers, with possible perforation and bleeding
- abdominal swelling
- impaired wound healing
- skin changes
- injection site reactions
- increased sweating
- heart failure
- convulsions
- development of Cushingoid state (symptoms of Cushing’s syndrome, which arise due to high cortisol levels)
- changes in blood sugar, which can manifest with diabetes-like signs and symptoms
- menstrual irregularities
- weight gain
- allergic reactions
Cortrophin Gel may mask signs of infections or other diseases. It also may cause other health issues that can warrant careful monitoring, including:
- eye problems such as cataracts or glaucoma
- fluid retention and salt imbalances
- high blood pressure
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
FAQs about Cortrophin Gel
Cortrophin Gel was first approved by the U.S. Food and Drug Administration (FDA) in 1954 to treat a number of inflammatory and autoimmune conditions, but its approval the management of acute multiple sclerosis (MS) relapses was not granted until 1977. While the therapy fell out of use for MS during the 1980s, the FDA approved its reintroduction into the U.S. market in 2021.
Animal studies suggest that Cortrophin Gel may cause harm to a developing fetus. Because of this, doctors should carefully weigh the potential benefits and risks before prescribing it to people who are pregnant or may become pregnant. Newborns exposed to the therapy during pregnancy should also be monitored for possible adrenal gland problems.
There’s no specific interaction between Cortrophin Gel and alcohol listed in the medication’s prescribing information. However, alcohol can interfere with some medications and worsen certain disease symptoms, so patients should ask their healthcare team whether and how much it is safe for them to drink.
In clinical studies, some people began to notice improvement within about three weeks of starting Cortrophin Gel treatment for a multiple sclerosis relapse. Response times, however, can vary, so healthcare providers are the best source of guidance on what to expect in each case.
Weight gain can occur in individuals on Cortrophin Gel treatment, but the therapy’s prescribing information does not list hair loss as a potential side effect. Patients should talk to their healthcare providers about any unanticipated effects from the medication.
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