Fludrocortisone: Uses, Dosage & Safety

When working with Fludrocortisone, a synthetic mineralocorticoid that replaces or supports the body’s natural salt‑retaining hormones. Also known as Florinef, it is primarily used to manage conditions where the adrenal glands can’t produce enough hormone.

One of the main conditions it treats is adrenal insufficiency, a disorder where the adrenal cortex fails to secrete adequate cortisol and aldosterone. Patients with this disorder often struggle with low blood pressure and sodium loss, so fludrocortisone helps restore fluid balance. In the hormonal chain, aldosterone, the body’s natural mineralocorticoid produced by the adrenal zona glomerulosa, works hand‑in‑hand with fludrocortisone to regulate sodium and potassium levels.

Key Considerations for Fludrocortisone Therapy

Understanding fludrocortisone means knowing how it influences electrolyte balance, the delicate equilibrium of sodium, potassium and water that keeps blood pressure stable. The drug boosts sodium reabsorption in the kidneys, which in turn raises blood volume and pressure—critical for patients who get dizzy or faint when standing. Dosage typically starts low, often 0.05 mg once daily, and is adjusted based on blood pressure, weight and serum electrolytes. Regular lab checks are a must because too much fludrocortisone can cause hypertension, edema or potassium depletion.

Side‑effects are usually mild but worth watching. Common complaints include headache, swelling of the ankles, or feeling overly salty. Rarely, patients develop high blood pressure that needs a separate antihypertensive. If you notice sudden weight gain, persistent fatigue, or muscle cramps, contact your provider—these could signal electrolyte shifts that need a dosage tweak.

Beyond adrenal insufficiency, fludrocortisone sometimes appears in the management of orthostatic hypotension and certain forms of congenital adrenal hyperplasia. In each case, the goal is the same: restore the body’s ability to hold onto sodium and water, keeping blood pressure within a healthy range. Below you’ll find a curated set of articles that dive deeper into dosage calculations, drug interactions, lifestyle tips for staying hydrated, and real‑world patient experiences with fludrocortisone therapy.