fludrocortisone acetate at a glance
Medicine class
Mineralocorticoid corticosteroid
Licensed roles
Hormone replacement in specified forms of adrenocortical insufficiency and treatment of salt-losing adrenogenital syndrome
Important checks
Blood pressure, fluid retention, weight and blood electrolytes require review
What is fludrocortisone acetate used for?
Selected UK products are licensed for:
Partial mineralocorticoid replacement in Addison’s disease and primary adrenocortical insufficiency.
The selected oral solution additionally specifies secondary adrenocortical insufficiency.
Salt-losing adrenogenital syndrome.
Fludrocortisone is also used outside its licence for some people with postural hypotension, but evidence of benefits and harms remains uncertain.
How does fludrocortisone acetate work?
It acts like the body’s mineralocorticoid hormones. It increases sodium and water retention by the kidneys, supports circulating blood volume and increases potassium excretion.
fludrocortisone acetate preparations and strengths
Oral solution
Route: Oral
Strengths: 0.1 mg/mL
Tablet
Route: Oral
Strengths: 0.05 mg, 0.1 mg
How to take fludrocortisone acetate
Take fludrocortisone exactly as prescribed and do not stop suddenly. Swallow tablets by mouth. Shake the oral solution well, measure it with the supplied oral syringe, release it slowly into the mouth, then wash and dry the syringe.
The selected tablet’s score line helps with swallowing but is not intended to provide equal portions.
The oily oral solution is not recommended for people with swallowing difficulties because of aspiration risk.
The oral solution can be given through specified nasogastric or gastrostomy tubes using the product instructions.
fludrocortisone acetate side effects
Common or expected effects
- Low blood potassium
- High blood pressure
- Fluid retention, swelling or weight gain
- Headache
- Muscle weakness
- Diarrhoea or reduced appetite
Get urgent medical advice
- Severe allergic reaction, including breathing difficulty or facial swelling
- Heart failure symptoms such as new breathlessness or worsening swelling
- Irregular heartbeat, fainting or seizures
- Severe mood or behavioural changes, hallucinations or suicidal thoughts
- Serious infection, which corticosteroids may make harder to recognise
- Gastrointestinal bleeding or perforation
fludrocortisone acetate in pregnancy
Mineralocorticoid replacement may need to continue because poorly controlled adrenal insufficiency can be serious. Anyone pregnant or planning pregnancy should contact their endocrinology and maternity teams for specialist monitoring, particularly if pre-eclampsia or fluid retention develops. Do not stop treatment without advice.
fludrocortisone acetate while breastfeeding
Fludrocortisone can be used cautiously during breastfeeding when clinically needed. Evidence is limited, but milk exposure is expected to be small during replacement therapy. Monitor the infant’s feeding, growth and weight gain, with additional assessment if exposure is substantial or prolonged.
fludrocortisone acetate interactions
Tell the prescriber or pharmacist about all prescribed, non-prescribed and herbal products. Important examples include:
Diuretics and amphotericin B
Potassium loss may increase, raising the risk of hypokalaemia and abnormal heart rhythms.
Digoxin and other digitalis glycosides
Low potassium can increase digitalis toxicity and arrhythmia risk.
Common questions about fludrocortisone acetate
Answers are fully visible for fast scanning and source review.
Is fludrocortisone acetate a steroid?
Yes. It is a corticosteroid with particularly strong mineralocorticoid activity.
Does fludrocortisone acetate increase blood pressure?
It can increase blood volume and pressure by retaining sodium and water. Excessive effects can cause hypertension, swelling or heart failure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.