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Overview: Fludrocortisone is used to treat certain conditions in which your adrenal glands cannot make enough hormones. It works by partially replacing low levels of steroid hormones. Common side effects include increased blood pressure, fluid retention, and low potassium levels. Serious side effects may include an increased risk of infections.

Uses

What is fludrocortisone used for?

Fludrocortisone is commonly used for certain people with the following conditions.

  • Addison’s disease, a condition in which your adrenal glands do not make enough essential hormones, leading to a variety of physical and mood-related symptoms
  • Androgenital syndrome, a condition in which your adrenal glands are unable to make certain hormones, leading to a hormonal imbalance that often impacts development of sex characteristics

Fludrocortisone may also be used for other conditions as determined by your health care provider.

How does fludrocortisone work (mechanism of action)?

Fludrocortisone belongs to a group of medicines called corticosteroids. It acts similarly to one of the steroid hormones that your body naturally makes and can partially replace low levels of steroid hormones in people with reduced adrenal gland function.

How is fludrocortisone supplied (dosage forms)?

Brands and other names

  • Florinef

Dosage forms and strengths

  • 0.1 mg oral tablets

How should I store fludrocortisone?

Fludrocortisone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not expose it to excessive heat.

Side Effects

What are the most common side effects of fludrocortisone?

The most common side effects of fludrocortisone are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Increased blood pressure (see below)
  • Fluid retention (see below)
  • Low potassium levels (see below)

There may be other side effects of fludrocortisone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada or by calling 866-234-2345.

What are the serious side effects of fludrocortisone?

While less common, the most serious side effects of fludrocortisone are described below, along with what to do if they happen.

Severe Allergic Reactions. Fludrocortisone may cause allergic reactions, which can be serious. Stop taking fludrocortisone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Infections. Fludrocortisone may increase your risk of infections, including serious infections. Call your health care provider right away if you have an infection or any of the following symptoms.

  • Burning or stinging when you pee 
  • Cough or coughing up blood
  • Fever, sweats, chills, or muscle aches
  • Shortness of breath
  • Diarrhea or stomach pain
  • Weight loss

Vision Problems. Fludrocortisone may cause cataracts or glaucoma, which can lead to blindness. Tell your health care provider right away if you have any of the following symptoms.

  • Cloudy or foggy vision
  • Nearsightedness
  • Changes in how you see colors
  • Problems with glare (such as traffic lights when driving at night)
  • Loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Increased Blood Pressure (Hypertension). Fludrocortisone may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

  • Sudden severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea or vomiting
  • Blurry or other changes to vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Fluid Retention (Edema). Fludrocortisone can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms. 

  • Chest pain
  • Irregular heartbeat
  • Shortness of breath
  • Stretched or shiny skin
  • Swollen body parts, such as the belly or ankles
  • Unusual weight gain

Low Potassium Levels (Hypokalemia). Fludrocortisone can cause a low potassium level, which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take certain other medicines. Keep all appointments to have your blood checked. Call your health care provider if you have any of the following symptoms of a low potassium level.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation

Mood Changes. Fludrocortisone may cause changes in your mental status, including trouble sleeping, mood swings, personality changes, and depression. Tell your health care provider if you notice any changes in mood, thoughts, or behaviors.

Reactivated Infections. Some types of microbes that cause infections (such as bacteria or viruses) can remain in the body after you recover from that infection. When a microbe stays in the body but does not cause an infection, it is called a “latent” microbe. Fludrocortisone may increase your risk of a latent microbe becoming active again, causing an infection. Before you start treatment with fludrocortisone, tell your health care provider if you have ever had tuberculosis (TB), hepatitis B, or any other serious infections.

Warnings & Precautions

Who should not use fludrocortisone?

Allergies to Ingredients. People who are allergic to any of the following should not take fludrocortisone.

  • Florinef
  • Fludrocortisone
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific fludrocortisone products they stock.

Whole-Body Fungal Infections. People who have fungal infections in their body should not take fludrocortisone.

What should I know about fludrocortisone before using it?

Do not take fludrocortisone unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share fludrocortisone with other people, even if they have the same condition as you. It may harm them.

Keep fludrocortisone out of the reach of children.

Do not stop taking fludrocortisone without talking to your health care provider. Stopping too quickly may cause serious side effects. If your health care provider tells you to stop fludrocortisone or lowers your dose, call them right away if you have any side effects.

Avoid exposure to chickenpox or measles while you are taking fludrocortisone. If you think you have been exposed to chickenpox or measles, tell your health care provider right away.

Follow any instructions from your health care provider about your diet, such as salt and potassium intake. 

Keep all appointments with your health care provider, including for blood tests and blood pressure checks. 

Tell your health care provider if you have any planned surgeries while taking fludrocortisone or within a year of stopping it. Also let them know if your body is under stress due to conditions such as severe illness or trauma. Your health care provider may need to adjust your dose of fludrocortisone during these times.

Fludrocortisone may affect the results of certain lab tests. Tell all of your health care providers that you are taking this medicine before any lab tests or blood tests.

What should I tell my health care provider before using fludrocortisone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if fludrocortisone is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Fludrocortisone may interact with other medicines and supplements. Before taking fludrocortisone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Vaccines. Talk with your health care provider about any vaccines that you may need. You should not receive certain vaccines right before or while taking fludrocortisone. Tell your health care provider about any vaccines you have recently received or have scheduled.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Pregnancy. It is not known if or how fludrocortisone could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. Fludrocortisone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take fludrocortisone while breastfeeding.

Interactions

Does fludrocortisone interact with foods or drinks?

There are no known interactions between fludrocortisone and foods or drinks.

It is unknown if drinking alcohol will affect fludrocortisone.

Does fludrocortisone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking fludrocortisone.

  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Digoxin (Lanoxin), which is a medicine used to treat an irregular heartbeat and some types of heart failure
  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • A medicine for diabetes
  • Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
  • A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • An anabolic steroid, which is a medicine used for a variety of conditions, including hormone replacement
  • Estrogen, which is found in certain birth control pills, patches, creams, rings, or vaginal suppositories 

This may not be a complete list of medicines that can interact with fludrocortisone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much fludrocortisone?

If you or someone else has used too much fludrocortisone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of fludrocortisone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.