Trade Names:Florinef Acetate- Tablets 0.1 mgFlorinef (Canada)
Exerts salt-retaining (mineralocorticoid) activity by acting on renal distal tubules to enhance reabsorption of sodium and increasing urinary excretion of potassium, hydrogen, and magnesium ions.
Fludrocortisone is rapidly absorbed from the GI tract. T max is 1.7 h.
The plasma t 1/ 2 is about 3.5 h. The biological t 1/ 2 is 18 to 36 h.
Partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison disease; treatment of salt-losing adrenogenital syndrome.
Treatment of severe orthostatic hypotension.
Systemic fungal infections.
PO 0.05 to 0.1 mg/day (range, 0.1 mg 3 times/wk to 0.2 mg/day).Salt-Losing Adrenogenital SyndromeAdults
PO 0.1 to 0.2 mg/day.
May increase potassium loss.Anticholinesterase agents (eg, neostigmine)
May antagonize the effects of anticholinesterase agents in myasthenia gravis.Anticoagulants (eg, warfarin)
Dose requirement of anticoagulant may be reduced or effect opposed.Barbiturates, hydantoins (eg, phenytoin), rifampin
Decreased fludrocortisone activity.Salicylates
Serum levels may be reduced by corticosteroids, decreasing the effectiveness; in addition, the ulcerogenic effects of both agents may be increased.
None well documented.
Edema; hypertension; CHF; heart enlargement.
Bruising; increased sweating; hives; rash.
Hypokalemic alkalosis. May also cause adverse reactions associated with glucocorticoids (eg, dexamethasone).
Category C .
Excreted in breast milk.
Safety and efficacy not established.
Patients with Addison disease may exhibit exaggerated adverse reactions; monitor closely for development of edema, significant weight gain, or increases in BP.
Adrenal insufficiency may occur. Increased doses may be needed before, during, or after stressful situations.
Sodium retention and potassium loss are increased by high sodium intake. Sodium restriction and potassium supplementation may be necessary.
Use with caution in patients with nonspecific ulcerative colitis if there is a possibility of impending perforation, abscess or other pyogenic infection, diverticulitis, fresh intestinal anastomoses, or peptic ulcer.
Drug may mask signs of infection and may decrease host-defense mechanisms to prevent dissemination of infection.
Because of possible hazards of neurological complications and a lack of antibody response, do not vaccinate patients against smallpox while receiving corticosteroid therapy or undertake other immunization procedures.
Prolonged use may produce posterior subcapsular cataracts and glaucoma with possible damage to the optic nerves and may enhance the establishment of secondary ocular infections caused by fungi or viruses.
Patients receiving fludrocortisone may need supplemental measures (eg, glucocorticoids, electrolyte control) for optimal control of symptoms.
Hypertension, edema, hypokalemia, excessive weight gain, increase in heart size.
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