Fludrocortisone
Adrenocortical Hyperfunction, Addison Disease
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
NO
Pharmaceutical Class
undefined
Controlled Drug Substance
NO
Fludrocortisone
Summary
Fludrocortisone is primarily used for Addison's disease, a condition where the adrenal glands do not produce enough steroid hormones. It is also prescribed for orthostatic hypotension, a condition causing dizziness upon standing due to low blood pressure. It also helps manage salt-wasting syndromes and other disorders affecting fluid balance.
Fludrocortisone works by mimicking the hormone aldosterone. This hormone helps the kidneys retain sodium and excrete potassium, maintaining blood pressure and fluid balance in the body.
The typical adult dose for Addison's disease is 0.05 to 0.2 mg once daily. For orthostatic hypotension, it is usually 0.1 mg daily, adjusted as needed. Children may require lower doses based on weight and condition. Fludrocortisone is taken orally.
Common side effects include high blood pressure, swelling, low potassium levels, and weight gain due to fluid retention. Serious risks include heart problems, bone thinning (osteoporosis), and immune suppression.
People with uncontrolled high blood pressure, heart failure, kidney disease, or severe infections should avoid fludrocortisone. It may worsen these conditions due to fluid retention and electrolyte imbalances. Patients with osteoporosis, diabetes or glaucoma should use it cautiously as it can worsen these conditions over time.
Indications and Purpose
How does Fludrocortisone work?
Fludrocortisone mimics aldosterone, a hormone that helps the body retain sodium and excrete potassium, keeping blood pressure stable. It affects the kidneys, increasing sodium absorption and water retention, which helps prevent dehydration and maintains circulatory function. This mechanism is vital for people with Addison’s disease or chronic low blood pressure.
Is Fludrocortisone effective?
Yes, fludrocortisone is highly effective in managing conditions like Addison’s disease and orthostatic hypotension. Studies show that it significantly improves blood pressure control, fluid retention, and electrolyte balance. However, its effectiveness depends on the correct dosage and regular monitoring to avoid complications like high blood pressure or potassium imbalances.
What is Fludrocortisone?
Fludrocortisone is a corticosteroid used to help regulate salt and water balance in the body. It is commonly prescribed for conditions like Addison's disease and orthostatic hypotension. The medicine works by mimicking the hormone aldosterone, which helps the kidneys retain sodium and excrete potassium, maintaining blood pressure and fluid balance. It is available in oral tablet form.
Directions for Use
For how long do I take Fludrocortisone?
Fludrocortisone is usually a long-term treatment, especially for Addison’s disease, as it replaces missing hormones. In cases like orthostatic hypotension, treatment duration may vary depending on response. Never stop taking this medicine suddenly, as it can cause withdrawal symptoms or worsen adrenal insufficiency. Your doctor will guide any dose adjustments.
How do I take Fludrocortisone?
Fludrocortisone is usually taken once daily, preferably in the morning to align with the body’s natural hormone cycle. It can be taken with or without food. However, consuming high-sodium foods may increase the risk of side effects. Regular potassium-rich foods (like bananas and oranges) may be recommended to balance potassium levels.
How long does it take for Fludrocortisone to start working?
Fludrocortisone starts working within a few hours after taking a dose, but noticeable improvements in symptoms like low blood pressure or dizziness may take a few days. If treating Addison’s disease, it may take several weeks for full effects. Regular blood tests are required to monitor the effectiveness and adjust the dose.
How should I store Fludrocortisone?
Store fludrocortisone tablets at room temperature (20-25°C), away from moisture and direct sunlight. Keep it in its original packaging, out of reach of children. Do not store in the bathroom, as humidity can degrade the medication. Dispose of expired medicine properly.
What is the usual dose of Fludrocortisone?
The typical adult dose for Addison’s disease is 0.05 to 0.2 mg once daily, while for orthostatic hypotension, it is usually 0.1 mg daily, adjusted as needed. Children may require lower doses based on weight and condition. Dosage should be determined by a doctor, as too much fludrocortisone can lead to high blood pressure and fluid retention.
Warnings and Precautions
Can Fludrocortisone be taken safely while breastfeeding?
Fludrocortisone is present in breast milk, but at low levels. While no serious effects on infants have been reported, caution is advised. If a mother needs to take fludrocortisone, the infant should be monitored for growth, weight gain, and electrolyte imbalances.
Can Fludrocortisone be taken safely while pregnant?
Fludrocortisone should only be used during pregnancy if absolutely necessary. While it may be required for Addison’s disease, high doses could affect fetal growth or cause fluid retention complications. Pregnant women should be closely monitored by their doctor for any potential risks.
Can I take Fludrocortisone with other prescription drugs?
Fludrocortisone can interact with diuretics, NSAIDs (like ibuprofen), diabetes medications, and blood pressure drugs. Diuretics may increase potassium loss, while NSAIDs can worsen fluid retention. Always inform your doctor about all medications you’re taking to prevent harmful interactions.
Is Fludrocortisone safe for the elderly?
Elderly patients taking fludrocortisone are at a higher risk of high blood pressure, fluid retention, and osteoporosis. Regular monitoring of electrolytes, blood pressure, and bone health is crucial. Dose adjustments may be needed to avoid complications.
Is it safe to drink alcohol while taking Fludrocortisone?
Drinking alcohol while on fludrocortisone is not recommended, as it can worsen dizziness, dehydration, and blood pressure fluctuations. Alcohol may also increase fluid retention and strain the kidneys. If you do drink, keep it to a minimum and stay hydrated. Always check with your doctor before consuming alcohol regularly.
Is it safe to exercise while taking Fludrocortisone?
Yes, exercising while taking fludrocortisone is generally safe and beneficial. However, because this medicine affects fluid balance, sweating excessively may lead to dehydration or electrolyte imbalances. Drink enough water, avoid overexertion, and listen to your body. If you feel dizzy or weak during workouts, rest and consult your doctor.
Who should avoid taking Fludrocortisone?
People with uncontrolled high blood pressure, heart failure, kidney disease, or severe infections should avoid fludrocortisone. It may worsen these conditions due to fluid retention and electrolyte imbalances. Patients with osteoporosis, diabetes, or glaucoma should use it cautiously, as it can worsen these conditions over time.