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Mineralocorticoid

Fludrocortisone

Brand names: Florinef

Fludrocortisone is a potent mineralocorticoid used (with a glucocorticoid) for replacement in adrenal insufficiency, and for some forms of postural (orthostatic) hypotension.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Dosage depends on the severity of the disease and the response of the patient. Patients should be continually monitored for signs that indicate dosage adjustment is necessary, such as remission or exacerbations of the disease and stress (surgery, infection, trauma) (see WARNINGS and PRECAUTIONS, General ). Addison's Disease In Addison's disease, the combination of fludrocortisone acetate tablets with a glucocorticoid such as hydrocortisone or cortisone provides substitution therapy approximating normal adrenal activity with minimal risks of unwanted effects. The usual dose is 0.1 mg of fludrocortisone acetate tablets daily, although dosage ranging from 0.1 mg three …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-05-19. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It acts on mineralocorticoid receptors to promote renal sodium and water retention and potassium excretion, supporting blood pressure and electrolyte balance.

Prescribing in practice

  • Monitor for sodium and fluid retention (oedema, raised blood pressure) and for low potassium.
  • In adrenal insufficiency it is given alongside glucocorticoid replacement; do not omit doses during illness.
  • Dose is titrated to blood pressure, postural symptoms and electrolytes.

Monitoring

Monitor blood pressure (lying and standing), electrolytes (sodium and potassium) and for fluid overload.

Counselling the patient

  • Report ankle swelling, breathlessness or marked weakness.
  • If you have adrenal insufficiency, do not miss doses and seek advice when unwell.

Evidence & guidelines

Standard mineralocorticoid replacement in adrenal insufficiency and an option for orthostatic hypotension.

Reference: NICE Addison's disease guidance; Society for Endocrinology Addison's guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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