Fludrocortisone belongs to a class of medicines known as corticosteroids (more commonly called steroids).
You must take fludrocortisone each day.
If you need any medical treatment, make sure the person treating you knows you are taking fludrocortisone tablets.
Your pharmacist will give you a blue 'Steroid Treatment Card' - carry this with you at all times.
|Type of medicine||Corticosteroid|
|Used for||Replacement treatment in people with Addison's disease or following surgical removal of the adrenal glands|
|Also called||Fludrocortisone acetate|
Fludrocortisone belongs to a group of medicines called corticosteroids. It is sometimes referred to simply as an oral steroid. It is used as a replacement treatment for people whose adrenal glands do not produce sufficient natural corticosteroids - a condition known as Addison's disease. It is also used for people who have had surgery to remove their adrenal glands and who therefore no longer produce natural corticosteroids.
The two natural corticosteroids which need replacing are called hydrocortisone (cortisol) and aldosterone. The body's natural hydrocortisone can be replaced by taking hydrocortisone as a tablet or injection, but a substitute medicine has to be used to replace the body's natural aldosterone. Fludrocortisone is the substitute medicine used. It is used because its action in the body is similar to that of aldosterone. It will help to regulate your blood pressure and blood salt level.
Before taking fludrocortisone
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking fludrocortisone it is important that your doctor or pharmacist knows:
- If you are pregnant or breastfeeding.
- If you have high blood pressure.
- If you have had a heart attack or have any other heart problems.
- If you have liver or kidney problems.
- If you (or anyone in your family) have diabetes or increased eye pressure (glaucoma).
- If you have weakened bones (osteoporosis).
- If you have an underactive thyroid.
- If you have ever had a mental health problem - for example, depression.
- If you have epilepsy.
- If you have had a stomach ulcer or an inflammatory bowel disorder.
- If you have any kind of infection, or if you have ever had tuberculosis (TB).
- If you (or anyone you are in close contact with) have recently had chickenpox, measles or shingles.
- If you have ever had a blood clot in an artery or vein.
- If you have a condition known as myasthenia gravis, which causes muscle weakness, or if you have ever developed muscle pain after taking a steroid medicine.
- If you are taking other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take fludrocortisone
- Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack and be careful to follow any printed instructions you have also been given. The leaflet will give you more information about fludrocortisone and a full list of side-effects which you may experience from taking it.
- Your doctor or pharmacist will tell you how many tablets to take. This information will also be on the label of the packet of tablets to remind you. It is important that you take fludrocortisone exactly as your doctor has told you. It is usual to take fludrocortisone once daily, just after breakfast.
- Try to take your dose at the same time each day, as this will help you to remember to take it. If you do forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
- Continue to take fludrocortisone tablets regularly each day - it is vital for your well-being. Fludrocortisone replacement treatment is almost always lifelong.
Getting the most from your treatment
- You will be given a 'Steroid Treatment Card' which says that you are on steroids and contains some important advice for you. It is important that you read this card and carry it with you at all times. It also contains details about your dose, the length of time you have been taking fludrocortisone, and who prescribed it for you. Please make sure that this information is kept up to date.
- If you are having an operation or dental treatment or any treatment for an injury, tell the person carrying out the treatment that you are taking fludrocortisone and show them your treatment card.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want you to have tests from time to time to make sure you remain free from some of the unwanted side-effects of treatment.
- If you become ill it is important that you make an appointment to see your doctor straightaway. Also, if you come into contact with anyone who has measles, shingles or chickenpox (or anyone who suspects they might have them), you should see your doctor as soon as possible.
- Make sure you get your next supply of tablets well in advance so that you never run out. People with Addison's disease are entitled to free NHS prescriptions.
- Some vaccines may not be suitable for you. If you need any immunisations, make sure you mention that you are taking fludrocortisone.
- If you need to buy any medicines, check with a pharmacist that they are suitable for you to take with your other medicines.
- Thinning of the bones (osteoporosis) is more common in people with Addison's disease compared to the general population. Regular exercise, a good diet and not smoking will all help to prevent the development of osteoporosis, or reduce its severity.
Can fludrocortisone cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the more common side-effects associated with fludrocortisone treatment.You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects usually improve as your body adjusts to the new medicine, but other unwanted effects may develop with long-term fludrocortisone treatment. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common fludrocortisone side-effects||What can I do if I experience this?|
|Fluid retention causing swollen feet and ankles||Whenever possible, sit with your feet up|
|Tummy (abdominal) pain, feeling sick or bloated, indigestion||Stick to simple meals and avoid rich or spicy foods|
|Muscle weakness or feeling tired||If this happens, do not drive and do not use tools or machines until you feel better|
|Mood or behavioural changes, especially at the beginning of treatment||If you become confused, anxious, irritable, have trouble sleeping or start having worrying thoughts about harming yourself, speak with your doctor as soon as possible|
|Increased appetite or weight gain, irregular periods in women||If any of these become troublesome, speak with your doctor|
|Long-term treatment may cause other unwanted effects||If you have any symptoms which cause you concern, you should arrange to see your doctor for advice|
If you experience any other symptoms which you think may be due to this medicine, discuss them with your doctor or pharmacist.
How to store fludrocortisone
- Keep all medicines out of the reach and sight of children.
- Store the tablets in a refrigerator (between 2° and 8°) and keep the container tightly closed.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that someone has taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Fludrocortisone acetate 0.1mg Tablets; Aspen Pharma Trading Ltd, The electronic Medicines Compendium. Dated November 2015.
British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London