No

Corticosteroid, Oral

Partial replacement therapy for primary and secondary adrenocortical insufficiency in Addison's disease; treatment of salt-losing adrenogenital syndrome

C

Known hypersensitivity to fludrocortisone; systemic fungal infections

Taper dose gradually when therapy is discontinued; use with caution with Addison's disease, sodium retention and potassium loss

1% to 10%:

Central nervous system: Convulsions, headache, dizziness

Dermatologic: Acne, rash, bruising

Endocrine & metabolic: Hypokalemic alkalosis, suppression of growth, hyperglycemia, HPA suppression

Gastrointestinal: Peptic ulcer

Neuromuscular & skeletal: Muscle weakness

Ocular: Cataracts

Miscellaneous: Diaphoresis

Symptoms of overdose include hypertension, edema, hypokalemia, excessive weight gain. When consumed in excessive quantities, systemic hypercorticism and adrenal suppression may occur; in those cases, discontinuation and withdrawal of the corticosteroid should be done judiciously.

Decreased effect:

Decreased corticosteroid effects by rifampin, barbiturates, and hydantoins

Decreased salicylate levels

Promotes increased reabsorption of sodium and loss of potassium from renal distal tubules

Absorption: Rapid and complete from GI tract, partially absorbed through skin

Protein binding: 42%

Metabolism: In the liver

Half-life: Plasma: 30-35 minutes; Biological: 18-36 hours

Time to peak serum concentration: Within 1.7 hours

Oral:

Adults: 0.1-0.2 mg/day with ranges of 0.1 mg 3 times/week to 0.2 mg/day

Addison's disease: Initial: 0.1 mg/day; if transient hypertension develops, reduce the dose to 0.05 mg/day. Preferred administration with cortisone (10-37.5 mg/day) or hydrocortisone (10-30 mg/day).

Salt-losing adrenogenital syndrome: 0.1-0.2 mg/day

Systemic use of mineralocorticoids/corticosteroids may require a diet with increased potassium, vitamins A, B₆, C, D, folate, calcium, zinc, and phosphorus, and decreased sodium. With fludrocortisone a decrease in dietary sodium is often not required as the increased retention of sodium is usually the desired therapeutic effect.

Monitor blood pressure and signs of edema when patient is on chronic therapy; very potent mineralocorticoid with high glucocorticoid activity; monitor serum electrolytes, serum renin activity, and blood pressure; monitor for evidence of infection

May cause dizziness

Barbiturates and carbamazepine may decrease corticosteroid effects; useful in the management of psychotropic-induced hypotension

No information available to require special precautions

No effects or complications reported

Take exactly as directed. Do not take more than prescribed dose and do not discontinue abruptly; consult prescriber. Take with or after meals. Take once-a-day dose with food in the morning. Limit intake of caffeine or stimulants. Maintain adequate nutrition; consult prescriber for possibility of special dietary recommendations. If diabetic, monitor serum glucose closely and notify prescriber of changes; this medication can alter hypoglycemic requirements. Notify prescriber if you are experiencing higher than normal levels of stress; medication may need adjustment. Periodic ophthalmic examinations will be necessary with long-term use. You will be susceptible to infection; avoid crowds or infected persons or persons with contagious diseases. You may experience insomnia or nervousness; use caution when driving or engaging in tasks requiring alertness until response to drug is known. Report weakness, change in menstrual pattern, vision changes, signs of hyperglycemia, signs of infection (eg, fever, chills, mouth sores, perianal itching, vaginal discharge), other persistent side effects, or worsening of condition. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Monitor blood pressure and signs of edema when patient is on chronic therapy; very potent mineralocorticoid with high glucocorticoid activity; monitor serum electrolytes, serum renin activity, and blood pressure; monitor evidence of infection; closely monitor patients with Addison's disease and stop treatment if a significant increase in weight or blood pressure, edema or cardiac enlargement occurs

Tablet: 0.1 mg