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fludrocortisone (Rx)Brand and Other Names:Florinef, Florinef Acetate

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 0.1mg
more...

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

Severe Orthostatic Hypotension (Off-label)

0.1 mg/day PO in combination with high salt diet and adequate fluid intake; may be increased in increments of 0.1 mg/wk; not to exceed 1 mg/day

Dosages >0.3 mg/day have not been shown to be beneficial and predispose patient to adverse effects

Dosage Forms & Strengths

tablet

  • 0.1mg
more...

Not FDA-approved for use in children

Adrenocortical Insufficiency/Addison Disease (Off-label)

0.05-0.1 mg/day PO in single daily dose or divided q12hr in combination with sodium chloride supplementation

Congenital Adrenal Hyperplasia (Off-label)

0.05-0.3 mg/day PO

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Interactions

Interaction Checker

fludrocortisone and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Acne

            Adrenal suppression

            Change in spermatogenesis

            Delayed wound healing

            Diabetes mellitus

            GI perforation

            Glucose intolerance

            Hepatomegaly

            Hypokalemic alkalosis

            Increased transaminases

            Insomnia

            Menstrual irregularity

            Myopathy

            Neuritis

            Osteoporosis

            Peptic ulcer

            Perianal pruritus

            Pituitary adrenal axis suppression

            Pseudotumor cerebri (on withdrawal)

            Psychosis

            Seizure

            Ulcerative esophagitis

            Urticaria

            Vertigo

            Weight gain

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            Warnings

            Contraindications

            Systemic fungal infection

            Documented hypersensitivity

            Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (<2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in maintenance of physiologic dosages (replacement therapy)

            Cautions

            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

            Thromboembolic disorders and myopathy may occur

            Delayed wound healing is possible

            Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

            Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

            Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

            Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts and has been associated with development of Kaposi sarcoma

            Myopathy has been reported

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Unknown whether drug is excreted in milk; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

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

            Absorption

            Bioavailability: 100%

            Peak plasma time: ≤1.7 hr

            Distribution

            Protein bound: 42%

            Metabolism

            Metabolized in liver

            Elimination

            Half-life: Plasma, 3.5 hr; biologic, 18-36 hr

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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