Fludrocortisone
Pronunciation: floo-droh-KOR-ti-sone.
- Generic name
- fludrocortisone acetate
- Brand names
- FLORINEF (Australia)
- Drug class
- Mineralocorticoid (synthetic corticosteroid)
- Form
- Tablet
- Route
- Oral
- Legal status
- Prescription-only medicine.
Availability and supply rules vary by country
Trade names by country: Canada
Australia: · Full directory
What fludrocortisone acetate is and how it works
Fludrocortisone is a potent synthetic mineralocorticoid used mainly as replacement therapy when the body does not make enough of its own corticosteroid hormones. (2)
It requires regular monitoring of blood pressure, weight, swelling, and blood salt (electrolyte) levels. Like other corticosteroids, it must not be stopped suddenly after prolonged use.
Mechanism of action: how fludrocortisone acetate works
Fludrocortisone is a potent synthetic mineralocorticoid that acts on the kidney to promote sodium retention and potassium excretion, restoring fluid and electrolyte balance in mineralocorticoid-deficient states; it also has some glucocorticoid activity. (2)
What fludrocortisone acetate is used for
Partial replacement therapy in Addison's disease (primary adrenocortical insufficiency)
Used for partial replacement therapy in primary adrenocortical insufficiency (Addison's disease), per current UK product information. (2)
Salt-losing adrenogenital syndrome
Used for treatment of salt-losing adrenogenital syndrome, per current UK product information. (2)
Before taking fludrocortisone acetate
Do not take / not appropriate for
- Do not take fludrocortisone if you have a systemic infection, unless your prescriber specifically directs otherwise with appropriate anti-infective treatment. (all products) (2)
Tell your clinician about
- High blood pressure, heart failure, or a tendency to fluid retention or swelling.
- Low blood potassium or other electrolyte problems.
- Any current infection.
- Upcoming vaccinations.
- Whether you have been taking a corticosteroid for a prolonged period, since it must not be stopped suddenly.
- Every other medicine you take.
- Pregnancy or breastfeeding.
How to take fludrocortisone acetate
- Take exactly as prescribed for your specific condition; this page does not provide a universal dose since it depends on blood pressure, weight, swelling, salt intake, electrolytes, and clinical response.
- Do not change your dose or stop taking fludrocortisone suddenly, especially after prolonged treatment, without talking to your prescriber first.
- If you have been taking fludrocortisone for a prolonged period, carry a steroid treatment card and show it to any healthcare professional who treats you, and tell your care team about any illness, injury, or upcoming surgery, since your dose may need temporary adjustment (a 'stress dose').
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
Follow the product instructions for missed doses, or ask your prescriber or pharmacist. Do not take a double dose to make up for a missed one.
Overdose
Contact your prescriber, pharmacist, or a poison-control/emergency service if an overdose is suspected.
Side effects
Effects mainly relate to fluid and salt balance and general corticosteroid effects. Report warning symptoms rather than adjusting treatment yourself.
Swelling (oedema) or weight gain
What to notice: Fluid retention is a recognised effect of this mineralocorticoid.
What to do: Tell your prescriber if swelling or weight gain is significant or rapid. (2)
Raised blood pressure
What to notice: Blood pressure is checked regularly during treatment.
What to do: Tell your prescriber about headaches or other symptoms that might relate to blood pressure changes. (2)
Nausea and vomiting
Incidence: Common
Headache
Incidence: Common
Low potassium (hypokalaemia)
What to notice: Muscle weakness, cramps, or an irregular heartbeat.
What to do: Contact your prescriber promptly; blood tests may be needed. (2)
Signs of infection
What to notice: Fever, chills, or a new infection anywhere in the body.
What to do: Contact your prescriber promptly, since fludrocortisone can mask normal infection warning signs. (2)
Serious warnings
Heart failure or severe fluid overload — urgent
Symptoms: Marked swelling, rapid weight gain, or breathlessness.
Action: Contact your prescriber urgently; a clinician will decide whether the dose needs to be adjusted. (2)
Adrenal crisis after stopping suddenly, or during illness, injury, or surgery — emergency
Symptoms: Severe weakness, dizziness, low blood pressure, nausea or vomiting, or collapse.
Action: Do not stop fludrocortisone suddenly after prolonged use. Seek urgent medical care and show your steroid card if you become unwell, cannot take your dose, or face surgery or a serious infection. (2)
Serious allergic reaction — emergency
Symptoms: Swelling of the face, lips, or throat, or difficulty breathing.
Action: Seek emergency medical help immediately. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Other medicines affecting potassium or blood pressure | Combined use can increase the risk of low potassium, high blood pressure, or fluid retention. | Tell your prescriber and pharmacist about all other medicines you take. (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Heart failure or hypertension
Fludrocortisone's fluid- and salt-retaining effect can worsen heart failure or high blood pressure; this needs close monitoring. (2)
Prolonged treatment
Anyone on prolonged fludrocortisone treatment should carry a steroid treatment card and never stop suddenly. (2)
Pregnancy and breastfeeding
Discuss the balance of benefits and risks with your prescriber before starting, stopping, or continuing fludrocortisone in pregnancy or while breastfeeding. (2)
Monitoring
Before starting
- Confirm the diagnosis requiring mineralocorticoid replacement.
- Baseline blood pressure, weight, and electrolyte levels.
During treatment
- Regular monitoring of blood pressure, weight, swelling, salt intake, and serum electrolytes.
- Watch for signs of low potassium, heart failure, or infection.
- Plan for temporary dose adjustment ('stress dosing') during illness, injury, or surgery.
- Never stop treatment suddenly after prolonged use.
Storage
Store as directed on the product label, out of reach of children.
Professional information
Clinician-facing context only. Use the current local product information for exact dosing.
United Kingdom / United States
Indication: Partial replacement therapy in Addison's disease; salt-losing adrenogenital syndrome
Dose summary: No universal dose is displayed; dosing is individualised based on blood pressure, weight, oedema, salt intake, electrolytes, and clinical response, per current local product information.
Renal context: Not detailed in the sources reviewed for this dossier. (1) (2)
Hepatic guidance
Not detailed in the sources reviewed for this dossier; use current local product information.
Overdose note
Not detailed in the sources reviewed for this dossier; manage suspected overdose supportively per local guidance, with attention to fluid and electrolyte status. (2)
Frequently asked questions
What is fludrocortisone acetate used for?
fludrocortisone acetate is prescribed for approved indications. Always follow your healthcare provider's guidance.
What are the side effects of fludrocortisone acetate?
Common side effects may include gastrointestinal symptoms and headache. Serious side effects require immediate medical attention.
Can I take fludrocortisone acetate with other medications?
Always inform your healthcare provider about all medications you are taking, including over-the-counter products and supplements.
What is the mechanism of action of fludrocortisone acetate?
Fludrocortisone is a potent synthetic mineralocorticoid that acts on the kidney to promote sodium retention and potassium excretion, restoring fluid and electrolyte balance in mineralocorticoid-deficient states; it also has some glucocorticoid activity. (2)
References
- Fludrocortisone acetate tablets — prescription drug labelU.S. National Library of Medicine DailyMed · United States · dated 2026-01-08 · accessed 2026-07-22 · source 1
- Fludrocortisone Acetate 0.1 mg Tablets — Summary of Product Characteristicselectronic Medicines Compendium · United Kingdom · dated 2026-03-01 · accessed 2026-07-22 · source 2
- FLORINEF fludrocortisone acetate 0.1 mg tablets — ARTG 54688Therapeutic Goods Administration · Australia · dated 1996-03-19 · accessed 2026-07-22 · source 3
Brand names by country
Single-ingredient fludrocortisone acetate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
Canada
- FLORINEF