fludrocortisone (Florinef) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

DRUG INTERACTIONS: 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.

PREGNANCY: Use of oral fludrocortisone during pregnancy has not been adequately evaluated. Due to the lack of safety data, oral fludrocortisone should be used in pregnancy only if clearly needed. Corticosteroids when needed in pregnancy are generally used at the lowest effective dose for the shortest duration, and high doses during the first trimester are avoided.

Fludrocortisone may be used to treat congenital adrenal hyperplasia in pregnant women. Oral fludrocortisone is classified as FDA pregnancy risk category C (Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks).

NURSING MOTHERS: 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.

SIDE EFFECTS: Reported side effects include heart problems, fluid retention, high blood pressure, mood or psychiatric disorders, headache, trouble sleeping, skin problems, endocrine disorders, hyperglycemia, hypokalemia (low potassium), growth suppression, upset stomach, stomach ulcers, muscle weakness, osteoporosis, fractures, eye problems, and sweating. Fludrocortisone may increase risk of infections.

REFERENCE: FDA Prescribing Information.

Medically Reviewed by a Doctor on 4/16/2014

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