Medication description: Fludrocortisone (Fludrocortisone)

FLUDROCORTISONE (Fludrocortisone).

Synonyms: Cortineuf, Florinef, Alfanonidrone, Cortinef, Florinef, Fludronil and others.

The chemical name: (11beta) -9-Fluoro-11,17,21-trihydroxypregn-4-ene-3,20-dione (and as the 21-acetate)

Pharmacology: Pharmacological action - mineralocorticoid, glucocorticoid.
Increases blood pressure, reabsorption of sodium, water and secretion of potassium in the renal tubules. Oppresses the production of ACTH, the function of the adrenal glands, stimulates gluconeogenesis, the breakdown of proteins (causes a negative nitrogen balance), exhibits immunosuppressive and anti-inflammatory activity; With local application reduces itching and exudation. Well absorbed from the digestive tract. Easily passes gistogematicheskie barriers. T _1/2 - 18-36 h. It is excreted in the urine in the form of metabolites. A small part is excreted by lactating mammary glands.

Application: Primary and secondary adrenal insufficiency, adrenogenital syndrome with pronounced loss of electrolytes; Locally in ophthalmic practice: keratitis, allergic diseases and eye injuries.

Contraindications: Hypersensitivity, heart failure, hypertension, hyper- and hypothyroidism, osteoporosis, violations of liver and kidney function, systemic and local mycoses, herpes, chronic infections, diabetes, peptic ulcer, diverticulitis, mental disorders, pregnancy and lactation; For topical application - fungal and bacterial lesions of the eyes.

Side effects: Adrenal insufficiency, myasthenia gravis, gastrointestinal erosion, increased glucose level, hyperkalemia, hypertension, headache, dizziness, euphoria, emotional lability, increased intraocular pressure (inside, locally), cataract formation (locally), menstrual irregularities, slower growth In children, swelling.

Interaction: Increases the effectiveness (and toxicity) of systemic gluco- and mineralocorticoids, reduces - anabolic steroids (but increases their hepatotoxicity), oral antidiabetic drugs. Increases the likelihood of side effects in the appointment of cardiac glycosides, agents that cause hypokalemia (diuretics, amphotericin B). Against the background of sodium-containing drugs, the risk of edema and hypertension, acetylsalicylic acid and other NSAIDs increases - ulceration of the gastric mucosa. Psychotropic drugs and alcohol stimulate elimination.

Overdose: Symptoms: arrhythmia, hypokalemia, hypertensive crisis, edema, weight gain.

Dosing and Administration: Inside - from 0.1 mg 3 times a week to 0.2 mg once a day. With chronic adrenal insufficiency and adrenogenital syndrome - 0,1-0,2 mg / day together with hydrocortisone (10-30 mg / day), long; Ophthalmic ointment: pawned for a lid 1-3 times a day, no more than 2 weeks.

Precautions: Regular monitoring of blood pressure, potassium levels and glucose in the blood is necessary.