Vonity

Indications

Fludrocortisone acetate is a hormone medicine used to replace aldosterone, a salt-regulating hormone made by the adrenal glands. It is used in Addison's disease (adrenal insufficiency), usually together with Hydrocortisone, and in salt-losing congenital adrenal hyperplasia. Doctors sometimes also use it for certain types of low blood pressure on standing (orthostatic hypotension).

How It Works

Fludrocortisone acts on the kidneys to hold on to sodium (salt) and water and to pass out potassium. This increases blood volume and helps keep blood pressure and body salt balance normal when the body does not make enough aldosterone.

Dosage and Administration

Take by mouth exactly as prescribed. The dose is small and is adjusted by the doctor based on blood pressure, blood salts and symptoms. Do not stop taking it suddenly. During illness, vomiting or surgery, patients with adrenal insufficiency need urgent medical advice on their steroid cover.

Interactions

• Diuretics such as Furosemide or Hydrochlorothiazide, and Amphotericin B, can increase potassium loss.
• Digoxin: low potassium raises the risk of heart rhythm problems.
• Rifampicin, Phenytoin and Barbiturates can reduce its effect.
• NSAIDs such as Ibuprofen can increase fluid retention.
• It may change the effect of anticoagulants such as Warfarin and of diabetes medicines.

Contraindications

• Allergy to fludrocortisone.
• Untreated systemic fungal infections.
• Use in conditions such as heart failure or high blood pressure only with great caution under specialist care.

Side Effects

Possible effects include swelling of the ankles, weight gain from fluid, high blood pressure, low potassium (causing muscle weakness or cramps), headache and, with higher doses over a long time, typical steroid effects such as thinning bones, mood changes and easy bruising.

Get urgent medical help for shortness of breath, sudden swelling, chest pain, very high blood pressure, severe muscle weakness, an irregular heartbeat, or signs of adrenal crisis such as severe vomiting, fainting or confusion.

Pregnancy and Lactation

Women with adrenal insufficiency usually need to continue treatment during pregnancy, with doses reviewed by the doctor. It may pass into breast milk; breastfeeding is often possible but should be discussed with the doctor.

Precautions and Warnings

• Carry a steroid card and tell every doctor or dentist you take it.
• Regular checks of blood pressure, weight and blood potassium and sodium are needed.
• Your doctor may advise a lower-salt diet and potassium-rich foods.
• Avoid contact with chickenpox or measles if you have not had them, and seek advice if exposed.

Overdose

Overdose can cause high blood pressure, swelling, low potassium and weakness. Seek medical help; the dose will be stopped or reduced and blood salts corrected.

Therapeutic Class

Mineralocorticoid (corticosteroid hormone).

Storage

Store as directed on the pack; many products need to be kept in a refrigerator at 2 to 8°C, others below 30°C. Keep dry, away from light and out of the reach of children.