Approved indication:

• Edematous state: to induce a diuresis or a remission of proteinuria in the nephrotic syndrome without uremia of the idiopathic type or that due to lupus erythematosus¹¹

MOA:

• Potential indirect and direct anti-inflammatory and immunomodulatory effects
  • Indirect: stimulates release of endogenous corticosteroids
  • Direct: stimulates melanocortin receptors (MCRs) on podocytes and immune cells, potentially leading to inhibition of pro-inflammatory molecules/processes²⁴

Dosing:

• Usual dose is 40-80 units given intramuscularly or subcutaneously every 24-72 hours
• Dosage should be individualized according to the disease under treatment and the general medical condition of each patient. It may be necessary to taper the dose and increase the injection interval to gradually discontinue the medication

Adverse effects:

• Fluid retention, alteration in glucose tolerance, elevation in blood pressure, behavioral and mood changes, increased appetite and weight gain¹¹