Fludrocortisone

Fludrocortisone is a prescription medication used to treat Adrenocortical Insufficiency/Addison Disease, Salt-Losing Forms of Congenital Adrenogenital Syndrome.  

• Fludrocortisone is available under the following different brand names: Florinef, Florinef Acetate

Adult dosage

Tablet

• 0.1mg

Adrenocortical Insufficiency/Addison Disease

Adult dosage

• Usual, 0.1 mg/day orally; range, 0.1 mg orally 3 times weekly to 0.2 mg/day orally
• If hypertension occurs: 0.05 mg/day orally

Salt-Losing Forms of Congenital Adrenogenital Syndrome

Adult dosage

• 0.1-0.2 mg/day orally

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Fludrocortisone include:

• increased blood pressure, 
• stomach pain, 
• bloating, 
• facial redness, 
• acne, 
• increased sweating, 
• sleep problems (insomnia), 
• pitting, scars, or bumps under the skin, 
• stretch marks, and
• increased hair growth or body hair

Serious side effects of Fludrocortisone include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• swelling of feet or lower legs, 
• rapid weight gain, 
• muscle weakness, 
• loss of muscle mass, 
• blurred vision, 
• tunnel vision, 
• eye pain, 
• seeing halos around lights, 
• bloody or tarry stools, 
• coughing up blood, 
• unusual changes in mood or behavior, 
• seizure, 
• severe headaches, 
• ringing in the ears, 
• dizziness, 
• nausea, 
• vision problems, 
• pain behind the eyes, 
• leg cramps, 
• constipation, 
• irregular heartbeats, 
• fluttering in the chest, 
• increased thirst or urination, 
• numbness or tingling, 
• muscle weakness, 
• limp feeling, 
• severe pain in the upper stomach spreading to the back, 
• nausea, 
• vomiting, 
• weight gain in the face and shoulders, 
• slow wound healing, 
• skin discoloration, 
• thinning skin, 
• increased body hair, 
• tiredness, 
• mood changes, 
• menstrual changes, and
• sexual changes

Rare side effects of Fludrocortisone include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Fludrocortisone has severe interactions with the following drug:
  • mifepristone
• Fludrocortisone has serious interactions with at least 66 other drugs. 
• Fludrocortisone has moderate interactions with at least 214 other drugs. 
• Fludrocortisone has minor interactions with at least 108 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Systemic fungal infection
• Documented hypersensitivity 
• Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (less than 2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in maintenance of physiologic dosages (replacement therapy)

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Fludrocortisone?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Fludrocortisone?”

Cautions

• Use with caution in diabetes mellitus, hypertension, hypothyroidism, electrolyte abnormalities, sodium and water retention, infections, immunizations, ocular herpes simplex, myasthenia gravis, peptic ulcer disease, psychosis, renal insufficiency
• Thromboembolic disorders and myopathy may occur
• Delayed wound healing is possible
• Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
• Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)
• Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy
• Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts and has been associated with development of Kaposi sarcoma
• Myopathy has been reported

Pregnancy and Lactation

• Use with caution if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies done.
• Lactation: Unknown whether the drug is excreted in milk; use with caution.