Fludrocortisone Acetate
Indications
Fludrocortisone Acetate is used for:
Primary and secondary adrenocortical insufficiency in Addison disease, Salt-Losing Forms of Congenital Adrenogenital Syndrome
Adult Dose
Oral
Adult:
Primary adrenocortical insufficiency
Adrenocortical Insufficiency/Addison Disease
Primary and secondary adrenocortical insufficiency in Addison disease
Usual, 0.1 mg/day PO; range, 0.1 mg PO 3 times weekly to 0.2 mg/day PO
If hypertension occurs: 0.05 mg/day PO
Salt-Losing Forms of Congenital Adrenogenital Syndrome
0.1-0.2 mg/day PO
Child Dose
Not FDA-approved for use in children
Renal Dose
Administration
Contra Indications
Hypersensitivity. Hyperalbuminaemia; hypertension, systemic fungal infections.
Precautions
Use with caution in diabetes mellitus, hypertension, hypothyroidism, electrolyte abnormalities, sodium and water retention, infections, immunizations, ocular herpes simplex, myasthenia gravis, peptic ulcer disease, psychosis, renal insufficiency. Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts and has been associated with development of Kaposi sarcoma
Lactation: Unknown whether drug is excreted in milk; use with caution
Pregnancy-Lactation
Pregnancy category: C
Lactation: Unknown whether drug is excreted in milk; use with caution
Interactions
May decrease salicylate levels. Anticholinesterase effects are antagonised. Decreased effects with rifampin, barbiturates, hydantoins and phenytoin. Oral contraceptives or ritonavir may increase the plasma concentrations of fludrocortisone. Increased potassium loss with potassium-depleting drugs e.g. thiazides, furosemide or amphotericin B. Increased risk of GI bleeding or ulceration with NSAIDs. May alter efficacy of anticoagulants when used concurrently.
Side Effects
Side effects of Fludrocortisone Acetate :
Acne, hypertension, sodium and water retention, potassium loss, dizziness, itching, skin rash, headache, convulsions, CHF, muscle weakness, hyperglycaemia, HPA and growth suppression, peptic ulcer, cataracts, raised intraocular pressure and reduced visual acuity. Insomnia, Menstrual irregularity, Myopathy, Neuritis, Osteoporosis
Mode of Action
Potent mineralocorticoid with high glucocorticoid activity; Fludrocortisone promotes increased reabsorption of sodium and excretion of potassium from renal distal tubules