Fludrocortisone

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Administration

  • Type: Corticosteroid
  • Dosage Forms: 0.1 mg oral tablets
  • Routes of Administration: PO
  • Common Trade Names: Florinef (note: brand discontinued in US)

Adult Dosing

  • Adrenal Insufficiency
    • 0.1 mg 3 times per week to 0.2 mg daily. Give with food or milk. Taper dose gradually to d/c.
  • Orthostatic Hypotension
    • 0.1 mg PO qD initially then may increase by 0.1 mg/d weekly up to a max of 1 mg/d (>0.5 mg rarely helpful). Taper dose gradually to d/c.

Pediatric Dosing

NOT FDA approved in children

  • 0.05-0.2 mg/day

Special Populations

Contraindications

  • Allergy to class/drug
  • Systemic fungal infections

Adverse Reactions

Serious

  • Secondary adrenal insufficiency
  • Elevated ICP, seizure
  • CHF, cardiomegaly, hypertension
  • Thrombophlebitis

Common

  • Bruising, petechiae
  • Impaired wound healing
  • Hyperglycemia, hypokalemia
  • Rash, urticaria
  • Peptic ulcer disease
  • Irregular menses, growth delay (children)
  • Headache, vertigo

Pharmacology

  • Half-life: 3.5 hours
  • Metabolism: Hepatic, kidney
  • Excretion: urine

Mechanism of Action

  • Very potent mineralocorticoid, also has glucocorticoid effects

Comments

See Also

References

Authors

Claire, Tom Heston