Mineralocorticoid
Fludrocortisone acetate
Brand names: Florinef
Adult dose
Dose: 50–300 micrograms OD; postural hypotension up to 400 micrograms OD
Route: PO
Frequency: OD
Clinical pearls
- Adrenal insufficiency (Addison's, CAH); orthostatic hypotension
- Co-administered with hydrocortisone in primary adrenal failure
Contraindications
- Systemic infection unless specific therapy given
Side effects
- Sodium/water retention
- Hypertension
- Hypokalaemia
- Oedema
- Cushingoid features at high dose
Interactions
- NSAIDs (oedema)
- Diuretics (hypokalaemia)
- Live vaccines (high dose)
Monitoring
- BP
- U&E
- Weight
Reference: BNF; Endocrine Society guidelines; https://bnf.nice.org.uk/drugs/fludrocortisone-acetate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016