Fludrocortisone

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

• Pregnancy Rating: C
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing: no adjustment
• Hepatic dosing: no adjustment

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

See Also

• Corticosteroids
• Adrenal insufficiency