Fludrocortisone

Introduction

Fludrocortisone is a steroid with potent mineralocorticoid activity. It is used to treat:

• adrenocortical insufficiency
• postural hypotension
• adrenogenital syndrome

Generic Name	HA Code	Legal Classification
Fludrocortisone Acetate Tablet 100mcg	FLUD01	P1S1S3

Brand Name	HK Reg Number	Active Ingredients
FLORINEF TABLET 0.1mg	HK-00036	fludrocortisone acetate

Mechanism of Action

Fludrocortisone is a corticosteroid with glucocorticoid and highly potent mineralocorticoid activity.

Dosage

Fludrocortisone is used, usually with hydrocortisone, for replacement therapy in adrenocortical insufficiency.

Replacement therapy in adrenal insufficiency	Oral: 50-300 micrograms daily
severe orthostatic hypotension	Oral: 50-300 micrograms daily

It is also used ear drops in concentration of 0.1%.

Side Effects

Fludrocortisone acetate has glucocorticoid actions about 10 times as potent as hydrocortisone and mineralocorticoid effects more than 100 times as potent. Adverse effects are mainly those due to mineralocorticoid activity:

• sodium and water retention
• swelling due to fluid retention (oedema)
• hypertension
• increased excretion of potassium leading to hypokalaemia
• heart failure may be induced in susceptible patients

Other side-effects include:

steroid-induced diabetes	Raised blood sugar level
Osteoporosis, muscle wasting and weakenss	which is a danger, particularly in the elderly, as it can result in osteoporotic fractures for example of the hip or vertebrae