Fludrocortisone: Price, Dosage & Where to Buy

Fludrocortisone is a corticosteroid with strong mineralocorticoid activity, which means it helps the body retain salt and water. It is used as partial hormone replacement in Addison's disease, where the adrenal glands do not provide enough of the hormones the body needs. It is available as an oral tablet and requires a prescription in the United Kingdom.

Fludrocortisone acts like mineralocorticoid hormones, which help control the body's balance of salt and water. It acts on the kidneys so that more sodium, a component of salt, stays in the body rather than leaving in urine. Water follows sodium, helping maintain fluid levels and blood pressure.

This action also increases potassium loss. Too much salt and water retention can lead to swelling or raised blood pressure, so monitoring is part of treatment.

Fludrocortisone is used as partial replacement therapy for adrenal hormone deficiency in Addison's disease. The label describes its use for primary and secondary adrenocortical insufficiency. In Addison's disease, it is used alongside a glucocorticoid such as hydrocortisone or cortisone to replace adrenal hormone activity.

It is also indicated for salt-losing adrenogenital syndrome, a condition involving loss of salt from the body. Its strong effect on salt retention means the label advises against using it for conditions other than those listed.

The label lists oral tablets containing 0.1 mg of fludrocortisone acetate. The label lists a usual dose for Addison's disease of 0.1 mg daily, with a range from 0.1 mg three times a week to 0.2 mg daily. The label lists a reduction to 0.05 mg daily if temporary high blood pressure develops because of treatment.

Treatment for Addison's disease is described as combined replacement therapy with a glucocorticoid. The label lists accompanying cortisone at 10 mg to 37.5 mg daily in divided doses, or hydrocortisone at 10 mg to 30 mg daily in divided doses. The label lists 0.1 mg to 0.2 mg daily for salt-losing adrenogenital syndrome.

The dose depends on disease severity and the patient's response. Ongoing monitoring helps identify when adjustments are needed, including during surgery, infection or injury. Blood pressure, salt intake and blood electrolyte levels also need monitoring because of the medicine's strong salt-retaining effect.

The label specifies storage at 20° to 25°C. Avoid excessive heat and keep the tablets in a tightly closed, light-resistant container.

Keep this medicine out of the reach of children. The unit-dose packaging described in the label is not child resistant.

A missed dose can interrupt the regular hormone replacement this medicine provides. General pharmacy advice is to follow the missed-dose directions on the dispensing label and avoid doubling a dose to make up for one missed. If the timing is unclear or doses have been missed repeatedly, ask a pharmacist or prescriber for advice.

It is not known whether fludrocortisone can harm an unborn baby or affect reproductive capacity. Adequate animal reproduction studies have not been conducted with fludrocortisone, although many corticosteroids have caused developmental abnormalities in laboratory animals. Such effects have not been demonstrated in humans.

The label states that use during pregnancy should be limited to when clearly needed. Babies whose mothers received substantial doses during pregnancy should be observed for reduced adrenal activity, and maternal treatment should be recorded in the baby's medical notes. The label does not specify breastfeeding information; discuss this with a doctor or pharmacist.