Fludrocortisone | Side Effects, Dosage, Uses & MoreFludrocortisone is an oral medication used to treat Addison’s disease and salt-losing adrenogenital syndrome. Learn how it works, its warnings, and more.
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Generic Name:

fludrocortisone, Oral tablet

All Brands

  • Florinef (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 5

Highlights for fludrocortisone

Oral tablet
1

Fludrocortisone is an oral medication used to treat the adrenal gland diseases Addison’s disease and salt-losing adrenogenital syndrome (congenital adrenal hyperplasia).

2

Your dose depends on what condition you have and how you respond to the drug. Your doctor may adjust the dose based on your symptoms, whether your disease is stable, if you’re having a flare-up, or if your health has changed.

3

Common side effects include salt or water retention, weakened bones, and stomach ulcers.

4

In case of emergencies, carry medical identification that says you’re dependent on steroid medication, such as this one.

5

Fludrocortisone can weaken your immune system. This may make it easier for you to get an infection and harder for your body to fight off an infection.

IMPORTANT INFORMATION

May cause salt retention

Fludrocortisone can make you retain lots of salt (sodium) in your body. High amounts of salt in your body can lead to:

  • high blood pressure
  • water retention (swelling)
  • weight gain
  • low potassium levels, which may cause muscle aches or weakness, and abnormal heartbeat

Infection warning

Fludrocortisone can weaken your immune system. This may make it easier for you to get an infection and harder for your body to fight off an infection. Tell your doctor about recent infections or if you develop any symptoms of an infection. Symptoms may include fever, chills, and body aches. Avoid being near people who are sick or have recently been sick, especially with the chicken pox or measles. If you’re exposed to chickenpox or measles while taking this drug, be sure to tell your doctor.

Vaccine warning

Don’t receive any vaccines while you’re taking fludrocortisone. This could cause brain, spinal cord, and nerve problems. Also, your body may not be able to respond to the vaccine properly. This could make the vaccine unable to protect you from disease.

What is fludrocortisone?

Fludrocortisone is a prescription drug. It’s available as an oral tablet. It’s also available in a generic version. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it's used

This medication is used to treat Addison’s disease and salt-losing adrenogenital syndrome (also known as congenital adrenal hyperplasia).

How it works

Fludrocortisone is a steroid drug. It belongs to a class of drugs called corticosteroids.

More Details

How it works

Fludrocortisone is a steroid drug. It belongs to a class of drugs called corticosteroids. If your body isn’t producing enough of a certain steroid hormone, this drug will help to replace the shortage. This may help your body to perform necessary functions, such as retaining enough salt to function well.

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fludrocortisone Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with fludrocortisone include:

  • salt and water retention. This can lead to:

    • high blood pressure
    • swelling (edema)
    • growth in heart size
    • heart failure
  • low potassium. This can lead to:

    • muscle pain and weakness
    • abnormal heartbeat
  • weak, fragile bones (osteoporosis)

  • stomach ulcers

  • slow wound healing

  • thin or easily bruised skin

  • headaches

  • trouble sleeping

  • increased pressure in your eyes (glaucoma)

  • increased blood sugar levels

  • weight gain

  • deposits of fatty tissue throughout your body. This may cause a full, rounded face or a hump on your back.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • severe allergic reactions, including:

    • skin rash
    • hives
    • swelling of your lips, face, or tongue
  • infection. Symptoms may include:

    • fever
    • chills
    • body aches
  • changes in vision or pain in your eyes

  • changes in emotions or moods, including:

    • depression
    • mood swings
    • changes in personality
  • severe or continuing headaches

  • convulsions (seizures)

  • wounds that won't heal

  • heart failure. Symptoms may include:

    • unusual weight gain
    • swelling in your arms, legs, hands, or feet
    • trouble breathing
  • new or worsening diabetes. Symptoms may include:

    • high blood sugar levels
    • feeling thirsty all the time
    • feeling hungry all the time
    • needing to urinate more often
  • stomach ulcer or bleeding. Symptoms may include:

    • severe stomach pain
    • black, sticky stools
    • vomiting up blood
  • inflamed pancreas (pancreatitis). Symptoms may include:

    • severe stomach pain or upset
    • vomiting
    • severe back pain
  • low potassium levels. Symptoms may include:

    • muscle aches or weakness
    • muscle cramps
    • abnormal heartbeat
  • feeling extreme fatigue or weakness

  • breathing difficulty
  • peeling or blistering skin

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Mild side effects may go away within few days. Talk to your doctor or your pharmacist if they’re bothersome or don’t go away.

Fludrocortisone doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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fludrocortisone May Interact with Other Medications

Oral tablet

Fludrocortisone can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

Avoid drinking too much alcohol. Your body processes alcohol and fludrocortisone in similar ways. That means that if you drink alcohol, this drug might take longer to leave your body. You could experience worse side effects.

Medications that might interact with this drug

Fungal infection drug
  • amphotericin B

Combining these medications may increase the loss of potassium. Symptoms may include muscle pain and weakness, or an abnormal heartbeat.

Diuretics

This includes:

  • furosemide

Combining these drugs may increase the loss of potassium. Symptoms may include muscle pain and weakness, or an abnormal heartbeat.

Heart drug
  • digoxin

Combining these drugs may increase your risk of irregular heartbeat. Fludrocortisone may also increase your risk for digoxin side effects by lowering your potassium levels.

Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • aspirin
  • ibuprofen
  • naproxen
  • celecoxib

Combining these drugs may cause the NSAID not to work as well. It may also increase your risk of stomach and intestinal side effects.

Anticoagulants, blood thinners
  • warfarin

Combining this drug with fludrocortisone may increase or decrease the blood thinning effects of warfarin. Your dose may need to be adjusted by your doctor.

Diabetes drugs

These include oral drugs and insulin. Examples are:

  • metformin
  • glipizide
  • glimepiride
  • pioglitazone
  • linagliptin
  • sitagliptin
  • saxagliptin

If you take these drugs with fludrocortisone, they may not work as well. Your dose may need to be increased by your doctor.

Barbiturates, sedatives

These include:

  • phenobarbital

These drugs may decrease levels of fludrocortisone in your blood, causing it not to work as well. Your doctor may need to increase your fludrocortisone dose.

Antibiotic
  • rifampin

This drug may decrease levels of fludrocortisone in your blood, causing it not to work as well. Your doctor may need to increase your fludrocortisone dose. 

Seizure drug
  • phenytoin

This drug may decrease levels of fludrocortisone in your blood, causing it not to work as well. Your doctor may need to increase your fludrocortisone dose.

Male hormones (anabolic steroids)

These may increase risk of swelling. Use caution in taking these drugs together, especially if you have heart or liver disease.

Female hormones (estrogens)

These may increase the amount of fludrocortisone in your blood. Your doctor may need to decrease your fludrocortisone dose.

Vaccines

Don’t receive any vaccines while taking fludrocortisone. This could lead to brain, spinal cord, and nerve problems. Also, your body won’t be able to respond to the vaccine properly. This makes the vaccine unable to protect you from the disease it’s designed to prevent.

Mifepristone

Do not take this medication with mifepristone.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Fludrocortisone warnings
infections
People with infections

Taking fludrocortisone can make an infection worse. Tell your doctor if you have any signs or symptoms of an infection, such as fever, chills, or body aches, before you begin taking and while you take this medication.

tuberculosis
People with tuberculosis

Taking fludrocortisone may make an active tuberculosis infection worse. It can also cause tuberculosis to come back if you’ve had it before. Let your doctor know if you currently have or have ever had tuberculosis.

glaucoma
People with glaucoma

Taking fludrocortisone for a long time may increase the pressure in your eyes, causing damage to your eyes and vision. Your risk for other eye infections will also increase while you’re taking this medication. Let your doctor know if you have glaucoma or any other eye diseases.

ocular herpes simplex
People with ocular herpes simplex

Taking fludrocortisone may cause perforation, or small holes, in the outer layer of your eye (called the cornea). Let your doctor know if you have ocular herpes simplex.

heart disease
People with heart disease

This includes high blood pressure and heart failure. Taking fludrocortisone might cause your blood pressure to increase or make heart failure worse because it makes you retain salt and water. Let your doctor know if you have any heart problems.

diabetes
People with diabetes

Taking fludrocortisone can increase your blood sugar levels. You should monitor your blood sugar level more closely. Your doctor may need to increase the doses of your diabetes medications.

digestive system
People with stomach and intestine problems

These include ulcers, diverticulitis, and ulcerative colitis. Taking fludrocortisone may increase your risks for more ulcers, bleeds, or small holes in your stomach and intestines. Let your doctor know if you have a history of these stomach and intestine problems.

osteoporosis
People with osteoporosis

Taking fludrocortisone for a long time may make weak, fragile bones worse and increase your risk of broken bones. Let your doctor know if you have a history of osteoporosis.

liver
People with liver disease

If you have liver disease, the effects of fludrocortisone may be increased. You might need to take a lower dose. Let your doctor know if you have a history of liver disease. 

hypothyroidism
People with hypothyroidism

If you have underactive thyroid (hypothyroidism), the effects of fludrocortisone may be increased. You might need to take a lower dose. Let your doctor know if you have a history of thyroid disease.

brain
People with mood disorders

Fludrocortisone may cause mood swings, personality changes, trouble sleeping, severe depression, or psychosis. Let your doctor know if you have a history of severe depression or other psychiatric disorders.

pregnant women
Pregnant women

Fludrocortisone is a category C pregnancy drug. That means two things:

  1. Research in animals has shown harmful effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Speak with your doctor if you’re pregnant or plan to become pregnant. Fludrocortisone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

Corticosteroids may pass into your breast milk. This could cause side effects in your child if you breastfeed while taking fludrocortisone. You and your doctor may need to decide whether you’ll take fludrocortisone or breastfeed.

seniors
For seniors

If you’re 65 years or older, you may be more sensitive to the effects from this medication, including its side effects. Your doctor may give you a smaller dose because too much of this drug in your body can be toxic.

children
For children

The safety and effectiveness of this drug haven’t been established in children. Your doctor should monitor your child’s growth and development closely because this drug may slow down growth in children.

allergies
Allergies

Fludrocortisone can cause a severe allergic reaction. Symptoms may include:

  • · trouble breathing
  • · swelling of your face or throat
  • · hives or a rash

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal. 

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How to Take fludrocortisone (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Addison’s disease
Form: Oral tablet
Strength: 0.1 mg
Adult dosage (ages 18 years and older)
  • The usual dose is 0.1 mg per day.
  • Fludrocortisone is recommended in combination with cortisone (10–37.5 mg per day in divided doses) or hydrocortisone (10–30 mg per day in divided doses).
Child dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Warnings

  • Fludrocortisone should be used at the lowest effective dose. Doses should be decreased slowly to avoid major negative effects.
  • You may need additional doses in times of stress (such as trauma, surgery, or severe illness) to avoid further adrenal insufficiency caused by this drug.

Salt-losing adrenogenital syndrome
Form: Oral tablet
Strength: 0.1 mg
Adult dosage (ages 18 years and older)

0.1–0.2 mg per day.

Child dosage (ages 0-17 years)

Dosage for people younger than 18 years hasn’t been established.

Warnings

  • Fludrocortisone should be used at the lowest effective dose. Doses should be decreased slowly to avoid major negative effects.
  • You may need additional doses in times of stress (such as trauma, surgery, or severe illness) to avoid further adrenal insufficiency caused by this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Fludrocortisone comes with risks if you don’t take it as prescribed by your doctor.

If you change your dose or stop suddenly

Don’t change your dose or stop taking fludrocortisone without talking with your doctor. Stopping the medication suddenly can cause a disruption in your body’s hormones. This can lead to severe effects, including fatigue, weakness, low blood pressure, body aches and pain, fever, confusion or coma. These are especially possible if you’ve been on high doses for a long time. The dose should always be decreased slowly.

If you take too much

If you take too much of fludrocortisone, you may develop high blood pressure, swelling, loss of potassium, increased heart size, or noticeable weight gain. Call your doctor or get emergency medical help right away if you take or think you’ve taken too much or if you experience any of these symptoms.

What to do if you miss a dose

If you miss a dose, take it as soon as possible. However, if it’s almost time for the next dose, skip the missed dose and take the next dose at the usual time.

Don’t double the next dose. This could result in toxic side effects.

How can I tell if the drug is working?

You may be able to tell if this drug is working if you experience reduced symptoms of salt loss, such as low blood pressure, lightheadedness when you stand up quickly, tiredness, and cravings for salty foods.

Your doctor may monitor your symptoms and do blood tests to make sure the drug is working well for you.

This is a long-term medication.

Important considerations for taking fludrocortisone
take with or without food
You can take fludrocortisone with or without food
clock
If you take your dose once a day, you should take it in the morning
can crush tablet
You can cut or crush the oral tablet
storage
Store this medication in temperatures from 59–86°F (15–30°C). Avoid excessive heat
refillable prescription
Prescription is refillable
luggage
Travel
See Details
clinical monitoring
Clinical monitoring
See Details
diet
Your diet
See Details

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.

Clinical monitoring

Your doctor may perform tests to check your health and make sure the drug is safe and working for you. They include:

  • blood tests, which may include:
    • blood sugar levels. Fludrocortisone can increase your blood sugar and risk for diabetes.
    • serum electrolytes (sodium, potassium, calcium). Fludrocortisone works by helping you keep salt (sodium) in your body and lose potassium and calcium.
  • bone density tests. Fludrocortisone can increase your risk for osteoporosis because it causes you to lose more calcium.
  • eye tests. Fludrocortisone can increase the pressures inside your eyes and lead to glaucoma.
  • blood pressure. Fludrocortisone can increase your blood pressure because it helps you retain more salt, which results in retaining more water.

Your diet

This drug prevents your body from losing salt. You may need to decrease the amount of salt in your diet.

Fludrocortisone may make you lose potassium, so you might need to take potassium supplements.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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How Much Does fludrocortisone Cost?

Oral tablet

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on May 15, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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