Florinef

What is it?

A corticosteroid, mineralocorticoid preparation produced in the form of scored, pink tablets coded 429 and marked SQUIBB, containing 0.1mg fludrocortisone acetate. Mineralocorticoids regulate the saltwater balance in the body.

Medical Uses

Treatment of salt-losing adrenogenital syndrome and to partially replace hormones in Addison's disease.

Dosage

Adults, 0.05-3mg each day; children, according to body weight, age and condition being treated.

Special Care

Elderly, pregnancy, breastfeeding, only for short-term treatment in children. Infections, especially tuberculosis, fungal and viral. Liver failure, cirrhosis, kidney disor ders, congestive heart failure, recent heart attack, diarrhoea of unknown cause, ulcerative colitis, stomach ulcer, diverticulitis, recent scar tissue affecting digestive tract, inflammatory conditions of the veins, glaucoma. Also, cancers that have spread, diabetes, certain skin diseases, high blood pressure, psychotic conditions, epilepsy, osteoporosis, herpes simplex infections affecting the eyes, cerebral malaria, under-active thyroid gland, stress, previous steroid myopathy, intercurrent illnesses, myasthenia gravis. Also, accidental injuries and planned surgery - patient must be monitored. Patients should avoid exposure to measles infection - if inadvertently exposed, preventative treatment with immurioglobulins may be needed. Likewise, exposure to chickenpox or herpes zoster should be avoided - treatment with varicellazoster immunoglobulin may be required. Taking drug in morning or every second day helps to reduce risk of suppression of adrenal glands. Patients should carry a steroid treatment card'. treatment should be short-term. Withdraw treatment gradually.

Avoid Use

Whole body fungal infections, unless particular counter measures are being employed.

Possible Drug and Food Interactions

Anticholinesterases, phenobarbitone, cardiac glycosides, diuretics, carbamazapine, antihypertensives, anticoagulants taken by mouth, rifampicin, oestrogens, hypoglycaemics, phenytoin, aminoglutethimide, primidone, ephedrine, rifabutin. Also, salicylates, NSAIDs, cyclosporin, live vaccines, azole antifungals, carbenoxolone, erythromycin, methotrexate.

Known Side Effects

Depending upon dose and duration of treatment, steroid side effects including electrolyte disturbances and fluid imbalances, water retention, loss of potassium, gastrointestinal disturbance, central nervous system effects, salt retention, impaired wound healing, effects on bones, osteoporosis, cataracts, cushingoid effects, skin changes, depression, high blood pressure, glaucoma. Also, muscle weakness, stomach ulcer, hyperglycaemia, changes in sperm mobility, euphoria, mood swings. Also, retarded growth in children.