fludrocortisone (Florinef)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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What is fludrocortisone-oral, and how does it work (mechanism of action)?

Fludrocortisone is a man-made oral corticosteroid. It is derived from hydrocortisone, but is more potent than hydrocortisone. The effects of fludrocortisone including its effect on electrolyte balance and carbohydrate metabolism are stronger and prolonged in comparison to hydrocortisone.

Fludrocortisone mimics the actions of aldosterone which is a steroid that is naturally produced by the body. The physiological effects of fludrocortisone are dose dependent. Small oral doses of fludrocortisone cause an increase in blood pressure, sodium retention, and increases urinary potassium excretion. Larger doses of fludrocortisone inhibit the secretion of hormones from the adrenal gland. Fludrocortisone was initially approved by the US Food and Drug Administration (FDA) in 1954. The first generic fludrocortisone tablet was approved by the FDA in March 2002.

Is fludrocortisone-oral available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for fludrocortisone-oral?

Yes

What are the side effects of fludrocortisone-oral?

Reported side effects include:

Fludrocortisone may increase the risk of infections.

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What is the dosage for fludrocortisone-oral?

  • Addison's disease: The usual recommended dose is 0.1 mg by mouth once daily without regard to food. Dose should be reduced to 0.05 mg daily if hypertension develops. Maintenance dosage range is 0.1 to 0.2 mg 3 times weekly. Fludrocortisone is preferably administered with cortisone (10 to 37.5 mg daily) or hydrocortisone (10 to 30 mg daily).
  • Salt losing adrenogenital syndrome: The recommended dose is 0.1 to 0.2 mg daily.

Which drugs or supplements interact with fludrocortisone-oral?

: Antacids and bile acid sequestrants (for example, cholestyramine [Questran, Questran Light], colestipol [Colestid], and colesevelam [Welchol]) may decrease the absorption of oral corticosteroids.

Oral corticosteroids may decrease the effectiveness of diabetes medications.

Medications that may decrease blood levels of corticosteroids include barbiturates, isoniazid (Nydrazid, Laniazid, INH), mitotane (Lysodren), rifampin (Rifadin, Rifadin IV), aminoglutethimide (Cytadren), primidone (Mysoline), and others.

Medications that may increase blood levels of corticosteroids include aprepitant (Emend), strong CYP3A4 inhibitors, estrogen derivatives, mifepristone (Mifeprex), and others.

Corticosteroids may increase the risk of adverse effects associated with live vaccine administration.

Is fludrocortisone-oral safe to take if I'm pregnant or breastfeeding?

Although information specific to fludrocortisone is not available, corticosteroids are excreted in breast milk. Due to the risk of adverse effects in the infant, fludrocortisone should be used cautiously in nursing mothers.

What else should I know about fludrocortisone-oral?

What preparations of fludrocortisone-oral are available?

Tablets: 0.1 mg

How should I keep fludrocortisone-oral stored?

Tablets should be stored at room temperature between 2 C and 8 C (36 F and 46 F).

REFERENCE: FDA Prescribing Information.

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Reviewed on 9/29/2015
References
REFERENCE: FDA Prescribing Information.

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