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Fludrocortisone
From WikEM
Contents
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
