HEALTHY LIFESTYLE




Fludrocortisone acetate
Fludrocortisone acetate.JPG

Fludrocortisone acetate

CLINICAL USE

Replacement therapy in adrenal insufficiency

DOSE IN NORMAL RENAL FUNCTION

50–300 micrograms daily

PHARMACOKINETICS

  • Molecular weight                           :422.5
  • %Protein binding                           :70–80
  • %Excreted unchanged in urine     : 80% (as metabolites)
  • Volume of distribution (L/kg)       :Widely distributed
  • half-life – normal/ESRD (hrs)      :3.5 (Biological half-life 18–36 hours)

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in normal renal function
  • HD                     :Unknown dialysability. Dose as in normal renal function
  • HDF/high flux   :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: metabolism accelerated by rifamycins; metabolism possibly inhibited by erythromycin
  • Anticoagulants: efficacy of coumarins may be altered
  • Anti-epileptics: metabolism accelerated by carbamazepine, barbiturates, phenytoin and primidone
  • Antifungals: increased risk of hypokalaemia with amphotericin – avoid concomitant use; metabolism possibly inhibited by itraconazole and ketoconazole
  • Antivirals: concentration possibly increased by ritonavirCytotoxics: increased risk of haematological toxicity with methotrexateVaccines: high dose corticosteroids can impair immune response to vaccines – avoid concomitant use with live vaccines

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    Use for as short a time and as low a dose as possible
  • other drugs