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Management of primary adrenocortical insufficency, salt losing adreno-genital syndrom, and orthostatic hypotension

Fludrocortisone acetate, a synthetic adrenocortical steroid, possesses a very potent mineralocorticoid property and high glucocorticoid activity but is used only for its mineralocorticoid effects. It is believed to act by controlling the rate of protein synthesis. In small doses, it produces marked sodium retention and increased urinary potassium excretion while in large doses, it inhibits endogenous adrenal cortical secretion, thymic activity, and pituitary corticotropin excretion.

Elimination Half-life: 3.2hr

It is contraindicated in all conditions except those require a high degree of mineral-corticoid activity.

C [FDA]

Infant risk can not be ruled out.

Sodium retention, hypertension, potassium excretion; significant fluid retention may cause edema, dyspnea, weight gain and CHF. High doses cause suppression of hypophyseal corticotropin secretion.

PO, adult: 0.1-0.2mg/day, children: 0.05-0.1mg/day