Fludrocortisone

Fludrocortisone, sold under the brand name Florinef among others, is a corticosteroid which is used to treat adrenogenital syndrome, postural hypotension, and adrenal insufficiency. In adrenal insufficiency it is generally taken together with hydrocortisone. It is taken by mouth. The medication is most commonly used in its acetate form. Fludrocortisone, sold under the brand name Florinef among others, is a corticosteroid which is used to treat adrenogenital syndrome, postural hypotension, and adrenal insufficiency. In adrenal insufficiency it is generally taken together with hydrocortisone. It is taken by mouth. The medication is most commonly used in its acetate form. Common side effects include high blood pressure, swelling, heart failure, and low blood potassium. Other serious side effects include low immune system function, cataracts, muscle weakness, and mood changes. It is unclear if use during pregnancy is safe for the baby. Fludrocortisone is mostly a mineralocorticoid; however, also has glucocorticoid effects. Fludrocortisone was patented in 1953. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In the United Kingdom it costs the NHS about 1.52 pounds per month. In the United States the wholesale cost of a month of medications is about $11.96. Fludrocortisone has been used in the treatment of cerebral salt wasting syndrome. It is used primarily to replace the missing hormone aldosterone in various forms of adrenal insufficiency such as Addison's disease and the classic salt wasting (21-hydroxylase deficiency) form of congenital adrenal hyperplasia. Due to its effects on increasing Na+ levels, and therefore blood volume, fludrocortisone is the first line of treatment for orthostatic intolerance and postural orthostatic tachycardia syndrome (POTS).It can be used to treat low blood pressure. Fludrocortisone is also a confirmation test for diagnosing Conn's syndrome (aldosterone producing-adrenal adenoma), the fludrocortisone suppression test. Loading the patient with fludrocortisone would suppress serum aldosterone level in a normal patient, whereas the level would remain elevated in a Conn's patient. The fludrocortisone suppression test is an alternative to the NaCl challenge (which would use normal saline or NaCl tablets). Fludrocortisone is a corticosteroid and acts as a powerful mineralocorticoid along with some additional but comparatively very weak glucocorticoid activity. Relative to cortisol, it is said to have 10 times the glucocorticoid potency but 250 to 800 times the mineralocorticoid potency. Fludrocortisone acetate is a prodrug of fludrocortisone, which is the active form of the drug.