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.

Adverse 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

Mechanism of Action

Potent mineralocorticoid with high glucocorticoid activity; Fludrocortisone promotes increased reabsorption of sodium and excretion of potassium from renal distal tubules