- Adrenal Insufficiency (in combination with Glucocorticoids)
- Orthostatic Hypotension (some forms, off-label)
- See Systemic Corticosteroid
- Synthetic, halogenated Mineralocorticoid (with some Glucocorticoid activity)
- Acts at renal distal tubules and collecting ducts
- Induces permease, an enzyme regulator of cell permeability of Sodium
- Increases Sodium reabsorption and water retention
- Increases Potassium and Hydrogen Ion excretion
- Increases Sodium and water retention and expands intravascular volume
- Increases vascular alpha-adrenergic Receptor Sensitivity resulting in Vasoconstriction
- Acts at renal distal tubules and collecting ducts
- Fludrocortisone (Florinef) Tablet 0.1 mg
- Adult
-
Adrenal Insufficiency: 0.1 mg orally three times weekly up to 0.2 mg orally daily
- Administer in combination with Glucocorticoids (e.g. Hydrocortisone)
- Salt-Losing Adrenogenital Syndrome: 0.1 to 0.2 mg orally daily
-
Orthostatic Hypotension (off-label)
- Start at 0.1 mg daily
- Titrate weekly by 0.1 mg to maximum of 1mg daily
- Target improved symptoms
- Limit dosing if significant edema or weight gain >3.6 kg
- Monitor for Hypokalemia and Hypertension
- Risk of edema and Congestive Heart Failure exacerbation
- Risk of longterm Left Ventricular Hypertrophy and Renal Failure
- See Systemic Corticosteroid
- Volume overload
- Hypokalemia
- Hypomagnesemia
- Headache
- Edema
- Weight gain
- Supine Hypertension
- See Systemic Corticosteroid
- Pregnancy Category C
- Unknown safety in Lactation
- Fludrocortisone Tablet (DailyMed)
- (2003) Lexi-comp Drug Database
- Kim (2022) Am Fam Physician 105(1): 39-49 [PubMed]