Classes
DEA Class; Rx
Common Brand Names; Florinef, Florinef Acetate
- Corticosteroids
Description
Potent oral synthetic fluorinated mineralocorticoid; no appreciable glucocorticoid activity
Actions are similar to those of aldosterone
Used for conditions of adrenocortical insufficiency and orthostatic hypotension
Indications
Indicated for Primary and secondary adrenocortical insufficiency in Addison disease
Contraindications
Systemic fungal infection
Documented hypersensitivity
Receipt of live or attenuated live vaccine; Advisory Committee on Immunization Practices (ACIP) and American Academy of Family Physicians (AAFP) state that administration of live virus vaccines usually is not contraindicated in patients receiving corticosteroid therapy as short-term (<2 weeks) treatment, in low-to-moderate dosages, as long-term alternate-day treatment with short-acting preparations, or in maintenance of physiologic dosages (replacement therapy)
Adverse Effects
- Acne
- Adrenal suppression
- Change in spermatogenesis
- Delayed wound healing
- Diabetes mellitus
- GI perforation
- Glucose intolerance
- Hepatomegaly
- Hypokalemic alkalosis
- Increased transaminases
- Insomnia
- Menstrual irregularity
- Myopathy
- Neuritis
- Osteoporosis
- Peptic ulcer
- Perianal pruritus
- Pituitary adrenal axis suppression
- Pseudotumor cerebri (on withdrawal)
- Psychosis
- Seizure
- Ulcerative esophagitis
- Urticaria
- Vertigo
- Weight gain
Warnings
Use with caution in diabetes mellitus, hypertension, hypothyroidism, electrolyte abnormalities, sodium and water retention, infections, immunizations, ocular herpes simplex, myasthenia gravis, peptic ulcer disease, psychosis, renal insufficiency
Thromboembolic disorders and myopathy may occur
Delayed wound healing is possible
Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated
Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)
Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy
Prolonged corticosteroid use may result in elevated intraocular pressure, glaucoma, or cataracts and has been associated with development of Kaposi sarcoma
Myopathy has been reported
Pregnancy and Lactation
Pregnancy category: C
Lactation: Unknown whether drug is excreted in milk; use with caution
Maximum Dosage
Maintenance therapy usual max: 0.2 mg/day PO.
Maintenance therapy usual max: 0.2 mg/day PO.
Safety and efficacy have not been established, but doses of up to 0.3 mg/day PO have been used.
Safety and efficacy have not been established, but doses of up to 0.3 mg/day PO have been used.
Safety and efficacy have not been established, but doses of up to 0.3 mg/day PO have been used.
Safety and efficacy have not been established, but doses of up to 0.3 mg/day PO have been used.
How supplied
Fludrocortisone acetate
tablet
- 0.1mg
