Description of the medicine: Fludrocortisone (Fludrocortisone)
Synonyms: Cortinef, Florinnef, Alfanonidrone, Cortinef, Florinef, Fludronil, etc.
Chemical name: (11beta) -9-Fluoro-11,17,21-trihydroxypregn-4-en-3,20-dione (and in the form of 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 gland function, stimulates gluconeogenesis, protein breakdown (causes a negative nitrogen balance), shows immunosuppressive and anti-inflammatory activity; topical application reduces itching and exudation. It is well absorbed from the digestive tract. Easily passes histohematological barriers. T 1/2 - 18-36 hours. 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 severe loss of electrolytes; locally in ophthalmic practice: keratitis, allergic diseases and eye injuries.
Contraindications: Hypersensitivity, heart failure, hypertension, hyper- and hypothyroidism, osteoporosis, impaired liver and kidney function, systemic and local mycoses, herpes, chronic infections, diabetes, peptic ulcer disease, diverticulitis, mental disorders, pregnancy and lactation; for local use - fungal and bacterial lesions of the eyes.
Side effects: Adrenal insufficiency, myasthenia gravis, gastrointestinal erosion, increased glucose, hyperkalemia, hypertension, headache, dizziness, euphoria, emotional lability, increased intraocular pressure (inside, topically), cataract formation (topically), menstrual irregularities, growth retardation in children, swelling.
Interaction: Increases the effectiveness (and toxicity) of systemic gluco- and mineralocorticoids, reduces anabolic steroids (but increases their hepatotoxicity), and oral antidiabetic drugs. It increases the likelihood of side effects when prescribing cardiac glycosides, agents that cause hypokalemia (diuretics, amphotericin B). Against the background of sodium-containing drugs, the risk of developing 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 in conjunction with hydrocortisone (10-30 mg / day), for a long time; eye ointment: lay for an eyelid 1-3 times a day, no more than 2 weeks.
Precautions: Regular monitoring of blood pressure, potassium and glucose levels in the blood is required.