Fludrocortisone

Fludrocortisone: Uses, Dosage and Side Effects

Overview

• Aldosterone analogue increases potassium excretion and sodium retention.
• It has some glucocorticoid properties.

Uses of Fludrocortisone

• Treatment of adrenocortical insufficiency (Addison’s disease).
• As a mineralocorticoid, fludrocortisone is approximately 125 times more potent than hydrocortisone, but it is also approximately 12 times more potent as a glucocorticoid (and therefore approximately three times more potent than prednisolone).
• Monitor absolute sodium and potassium concentrations (not just the ratio) four to six hours after taking the drug.
• Some canines only require q24h dosing, but in these cases, sodium and potassium levels should be measured prior to dosing.
• In times of metabolic or physical stress, additional prednisolone dosage may be necessary.

Dose of Fludrocortisone in Dogs and Cats

Dogs:

• Hypoadrenocorticism: start at 0.01 mg/kg p.o. q12h.
• Most patients when stable require <0.05 mg/kg p.o. q12h.

Cats:

• Hypoadrenocorticism: doses as for dogs (very few reports).

Side Effects of Fludrocortisone in Dogs and Cats

• Hypertension, oedema (including cerebral oedema) and hypokalaemia with overdosage.
• Long-term overdose may result in clinical signs of hypercortisolism.

Contraindications of Fludrocortisone in Dogs and Cats

• No information is available.

Some Notes:

• Hypokalaemia may develop if fludrocortisone is administered concomitantly with amphotericin B or potassium-depleting diuretics (furosemide, thiazides)