Drug Interaction:
Reports not available
Indication:
Partial replacement of primary and secondary adrenocortical insufficiency in Addisons disease and for treatment of salt-losing adrenogenital syndrome Adrenocortical insufficiency in Addisons disease
Adverse Reaction:
Side effects may occur if dosage is too high or if withdrawal is too rapid. Because it possess glucocoticoid activity, fludrocorticosone may causecside effects similar to those of the glucocorticoids
Contra-Indications:
Hypersenitivity to fludrocorticosterone, systemic fungal infections
Warnings- Supplemental measures- use mineralocorticoid therapy preferably in conjunction with other supplemental measures( eg. glucocorticoids, control of electrolytes, control of infection)
Adrenal insufficiency- to avoid drug-induced adrenal insufficiency, supportive dosage may be required in times of stress ( eg, trauma, syrgery, severe illness ) both during treatment with fludrocortosone and for a year afterwards
Dosages/ Overdosage Etc:
Partial replacement of primary and secondary adrenocortical insufficiency in Addisons disease and for treatment of salt-losing adrenogenital syndrome
Adrenocortical insufficiency in Addisons disease
Dosage
Usual dose is 0.1mg/day (range 0.1mg 3 times a week to 0.2mg/day)
Children and adults- recommended dose is 0.05 to 0.1mg/24 hours
Infants- recommended dose is 0.1 to 0.2mg/24 hours
Overdosage-
Symptoms
Hypertension, edaema, hypokalemia, excessive weight gain or unusual weight gain occurs
Treatment
1. Notify physician if dizzinss,severe of continuing headches, swelling of feet or unusual weight gain occurs.
Other Information:
Adrenocortical insufficiency in Addisons disease Addisonian- like syndrome ( 1728 )
Adrenocortical hypofunction includes all conditions in which the secretion of adrenal steroid hormone falls below the requirements of the body.
Adrenal insifficiency may be divided into two general catogeries-
1. those associated with primary inability of the adrenal to eloborate sufficient quantites of the hormone
2. those associated with the secondary failure due in the elaboration of ACTH This disorder is called Addisons disease or chronic glcocorticoid defiency. Addisons description in 1855 namely, -general languor, and debility, remarkable feebleness of the heats action, irritability of the stiomach, and a peculiar change of the color of the skin summarizes the dominant features of the disease Drugs causin Advese reaction-
Busulfan
Patient Information:
Ref - USP PDI Vol II 17th Edition (1997)
1.Allergies-
Tell your doctor if you are have ever had any unusual or allergic reaction to
fludrocortisone. Also tell your healthcare care professional if you are allergic
to any other substances such as foods. preservatives or dyes.
2.Diet-
When flurocortisone is used to control certain types of kidney stones, too
much sodium may cause high blood blood sodium, high blood pressure
and excess body water
3.Pregnancy-
It is possible that too much use of this medicine during pregnancy may cause
the baby to have an underactive adrenal glands after birth.
4. Breast-feeding-
Fludrocortisone passes into breast milk and may cause problems with growth
or unwanted effects in the nursing baby.
5.Children-
Fludrocortisone may slow or stop growth in children or growing adolescents
when used for a long time. Follow doctors directions very carefully to lessen
the chances of unwanted effects
6.Older adults-
There is no specific information comparing use of fludrocortisone in the elderly with use
in other age groups.
7. Other medicines-
Tell your doctor if you are using any of the following medicines-
Acetozolamide or
Amphotericin B
Azlocillin or
Capreomycin or
Carbenicillin or
Dichlorphenamide or
Diuretics or
Insulins
Mezolocillin
Pipericillin
Vitamin D - fludrocortisone and these medicines decreases the amount of potassium
in the blood, which may increase the chance of low blood potasium
8. Other medical problems-
The presence of other medical problems may affect the use of fludrocortisone.
Make sure you tell your doctor if you have any other medical problems
Bone disease -flucortisone may make bone disease worse because it causes
more calcium to pass into the urine
Edema or
Heart blood pressure or heart dsease
Kidney disease - fludrocortisone causes the body to retain more salt and water.
These conditions may make it worse.
Liver disase
Thyroid disease- body may not get fludrocortisone out of bloodstream at the
usual rate,which increase the effect of fludrocortisone or cause more side
effects
Pharmacology/ Pharmacokinetics:
Pharmacology-
Fludrocorticosone is an adrenal cortical steroid with mineralocorticoid activity anfd high glucocorticoid activity ( about 15 times as potent asp[otent as hydrocortisone ) but is used only for its minewralocorticoid effects. Mechanism -mineralocorticoids act on the renal distal tubules to enhance the reabsorption of sodium.
Pharmacokinetics-
Fludrocortisone is readily absorbed from trhe GI tract with peak concentrations in 1.7 hrs . Plasma half-life is approximately 3.5 hrs.but biological half-life from 18 to 36 hours.
Pregnancy and lactation:
Pregnancy-
Safety for use during pregnancy has not been established. Use only when clearly needed and when the potential outweigh the potential hazards to the fetus. It is necesary to give steroids during pregnancy, observe the newborn infant for signs of adrenocortical insufficiency and institute appropriate therapy,if necessary.
Lactation-
Corticosteroids are found in the breast milk of lactaing women. Excercise caution when administering to nursing women.
Children-
Safety and efficacy for use in children have not been established. Monitor growth and development of infants and children on prolonged therapy.
Manufacturer Details