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**Tetracosactide hexaacetate** is a synthetic peptide analog of adrenocorticotropic hormone (ACTH), corresponding to the first 24 amino acids of natural ACTH (1-24 fragment), in the form of its hexaacetate salt. It acts as a potent agonist at the ACTH (melanocortin 2) receptor in the adrenal cortex, stimulating the synthesis and release of corticosteroids, including glucocorticoids, mineralocorticoids, and to a lesser extent, androgens. It is used primarily as a **diagnostic agent** for the assessment of adrenocortical insufficiency and, in some settings, for short-term therapeutic use where stimulation of endogenous corticosteroid production is desired (e.g., exacerbations of multiple sclerosis, certain rheumatic, neurological, and skin diseases, and infantile spasms/West syndrome). Unlike corticosteroid drugs, it induces a physiological spectrum of corticosteroids. The hexaacetate form offers improved stability and controlled-release pharmacokinetics for injectable use[1][3][5][7][8].
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