Medication Description: Fludrocortisone (Fludrocortisone)
Synonyms: Cortinef, Florinev, Alfanonidrone, Cortinef, Florinef, Fludronil, etc.
Chemical name: (11beta) -9-Fluoro-11,17,21-trihydroxypregn-4-ene-3,20-dione (and as 21-acetate)
Pharmacology: Pharmacological action - mineralocorticoid, glucocorticoid.
Increases blood pressure, reabsorption of sodium, water and potassium secretion in the renal tubules. It inhibits the production of ACTH, adrenal function, stimulates gluconeogenesis, the breakdown of proteins (causes a negative nitrogen balance), shows immunosuppressive and anti-inflammatory activity; when applied topically, reduces itching and exudation. Well absorbed from the digestive tract. Easily passes histohematic barriers. T 1/2 - 18-36 h. It is excreted in the urine as metabolites. A minor part is excreted by lactating mammary glands.
Application: Primary and secondary adrenal insufficiency, adrenogenital syndrome with severe electrolyte loss; locally in ophthalmic practice: keratitis, allergic diseases and eye injuries.
Contraindications: Hypersensitivity, heart failure, hypertension, hyper- and hypothyroidism, osteoporosis, disorders of the liver and kidneys, systemic and local mycoses, herpes, chronic infections, diabetes, peptic ulcer, diverticulitis, mental disorders, pregnancy and breastfeeding; for local use - fungal and bacterial eye damage.
Side effects: Adrenal insufficiency, myasthenia gravis, gastrointestinal erosion, increased glucose, hyperkalemia, hypertension, headache, dizziness, euphoria, emotional lability, increased intraocular pressure (inside, local), cataract formation (local), menstrual disorders, slower growth in children, swelling.
Interaction: Increases the effectiveness (and toxicity) of systemic gluco-and mineralocorticoid, 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.
Dosage and administration: Inside - from 0.1 mg 3 times a week to 0.2 mg 1 time per day. In chronic adrenal insufficiency and adrenogenital syndrome - 0.1-0.2 mg / day, together with hydrocortisone (10-30 mg / day), for a long time; eye ointment: lay in the eyelid 1-3 times a day, no more than 2 weeks.
Precautions: Requires regular monitoring of blood pressure, potassium levels and glucose in the blood.