What You Need to Know About Fludrocortisone

Fludrocortisone, also known by the brand name Florinef, is a synthetic corticosteroid, which assists your body in maintaining adequate sodium levels, fluids, and blood volume. Fludrocortisone also consists of anti-inflammatory and antiallergic properties, according to the Open Chemistry Database of the U.S. National Library of Medicine.

Fludrocortisone is a steroid. Although your body naturally produces varying levels of corticosteroids on its own, certain conditions may result in your body’s inability to make sufficient amounts. Medication may be required to control your body’s mineral and fluid levels.   

Fludrocortisone is only available with a prescription from your health care provider, and it comes in tablet form. The dose of the prescription will depend on the severity of your condition.  

Why Is Fludrocortisone Used?

If you have an illness such as Addison’s Disease—an endocrine disorder where your adrenal glands don’t produce enough steroid hormones—you may require treatment with fludrocortisone. In particular, the drug may be used when there’s a need for the body to retain greater amounts of sodium and lessen the amount that’s lost in the urine.

Treating Addison's Disease

In addition to sodium levels, potassium levels must also stay in balance. As the kidneys retain sodium through the use of fludrocortisone, the body excretes potassium via urine. Too much potassium can negatively impact the way muscles, including the heart, function. Thus, fludrocortisone can be used to reduce the levels of potassium in the blood. A body that’s in good health can maintain the sodium-potassium balance on its own. If an illness is present, fludrocortisone can help the body support this process.

Furthermore, the drug may be used to increase blood pressure in people with orthostatic intolerance (OI) issues, low blood pressure, and other conditions. 

How Is Fludrocortisone Taken?

Your doctor will determine the dose of the medication and when you should take it. The following guidelines may be useful to help you understand some specifics as to how to take it:

  • Fludrocortisone is a tablet that’s taken by mouth.
  • Generally, you can take the medication with or without food.
  • You’ll want to take your medication as prescribed.
  • Avoid taking too much or too little of your medication.
  • Don’t abruptly stop your medication.
  • If you need to decrease your dose, discuss this change with your doctor. Quickly stopping the medication can cause a host of unwanted side effects.
  • Your doctor will likely taper your dose down when it’s time to discontinue the drug.
  • If you miss a dose, take it as soon as possible. If the time to take your next dose is near, you’ll forgo the missed dose and resume your medication as prescribed.
  • Don’t double up on the dose if you forget to take the medication.

Side Effects

They may be some side effects associated with fludrocortisone, which can be mild to more severe. Although they may be bothersome, many of the side effects aren’t harmful. But if symptoms persist or reach beyond a tolerable level, talk with your doctor about what you’re experiencing. Side effects can include:

  • Stomach pain or irritation
  • Nausea
  • Vomiting
  • Headaches
  • Dizziness
  • A feeling of weakness
  • Restlessness
  • Insomnia
  • Agitation
  • Nervousness
  • Depression
  • Anxiety
  • Changes in menstrual period
  • Acne
  • Bloating or weight gain
  • Tendency to bruise easily
  • Changes in heartbeat

The following symptoms may be of greater concern—notify your doctor as soon as possible if you experience the following side effects when taking the medication:

  • Rash on your skin
  • Disturbances in your vision like loss of vision or blurriness
  • Swelling of the face, neck, fingers, legs, or ankles
  • Stools that are black, bloody, or tarry
  • Breathing changes
  • Difficulty swallowing
  • Severe weakness of the muscles
  • Flu-like symptoms or an infection that doesn’t seem to be improving

There may be additional side effects when taking fludrocortisone that aren’t listed here. Speak with your healthcare provider about any questions or concerns you may have while taking this drug.  

Precautions and Contraindications

This drug may not be right for you if you have any allergy to fludrocortisone, tartrazine (a yellow dye that may be an ingredient in the medication), or aspirin. Also, to prevent adverse drug reactions, be sure to tell your doctor all medications, whether prescription or over-the-counter, that you’re taking, especially blood thinners, diuretics, and antibiotics in the quinolone class.

If you have diseases that affect the liver, kidneys, heart, or gastrointestinal tract, be sure to notify your doctor. Additionally, talk to your physician about fludrocortisone if you’ve been diagnosed with diabetes, thyroid conditions, or high blood pressure. Make sure your healthcare provider has an accurate record of your medical history to assess whether this is the right medication for you.

If you’re pregnant, breastfeeding, or trying to get pregnant, it's very important to notify your doctor. To date, it’s not known how the drug impacts a fetus as no controlled studies have been performed.

When this drug is used in children, it could affect the speed at which a child grows and develops. Therefore, a routine monitoring schedule is advised for pediatric patients.   

Other Information

Depending on the illness, your doctor may want you to decrease your intake of sodium and increase your consumption of potassium-rich foods.

However, there are instances, such as in people with low blood pressure or orthostatic intolerance issues, where salt intake may be encouraged. When taking this medication, your doctor will prescribe individualized, dietary recommendations.

Keep in mind that you’ll need to take the medication as prescribed and not stop it abruptly. When it’s time to discontinue the drug, your doctor will slowly taper you off of it to avoid withdrawal symptoms. During times of extreme stress, however, you may need to increase your dose.

Finally, this medication may lower your resistance to infections, so be sure to contact your doctor if you’ve been exposed to chicken pox, measles, or other infectious diseases. You may also want to discuss which types of vaccines may or may not be appropriate for patients taking steroid medications.

A Word From Verywell

Your doctor will want to monitor you periodically while taking this medication. Changes in your health status, like periods of remission or flare-ups, could require an adjustment to your dosage. As always, if you experience unwanted side effects as a result of taking the medication or you have other questions or concerns, don’t hesitate to speak to your doctor or pharmacist to ensure the best treatment plan for you.

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