Fludrocortisone (Systemic)

Brand Names : Florinef

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For fludrocortisone, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to fludrocortisone. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - Your doctor may want you to control the amount of sodium in your diet. When fludrocortisone is used to treat certain types of kidney diseases, too much sodium may cause high blood sodium, high blood pressure, and excess body water.

Pregnancy - Studies on birth defects in humans have not been done with fludrocortisone. Adequate studies have not been done with fludrocortisone in animals, however many corticosteroids have been shown to cause birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - Fludrocortisone passes into the breast milk and may cause problems with growth or other unwanted effects in the nursing baby.

Children - Fludrocortisone may slow or stop growth in children or growing adolescents when used for a long time. The natural production of corticosteroids by the body may also be decreased by the use of this medicine. Before this medicine is given to a child or adolescent, you and your child's doctor should talk about the good this medicine will do as well as the risks of using it. Follow the doctor's directions very carefully to lessen the chance that these unwanted effects will occur.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of fludrocortisone in the elderly with its use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking fludrocortisone, it is especially important that your health care professional know if you are taking any of the following:

• Acetazolamide (e.g., Diamox) or
• Amphotericin B by injection (e.g., Fungizone) or
• Azlocillin (e.g., Azlin) or
• Bronchodilators (asthma medicine e.g., albuterol) or
• Capreomycin (e.g., Capastat) or
• Carbenicillin by injection (e.g., Geopen) or
• Corticotropin (ACTH) or
• Dichlorphenamide (e.g., Daranide) or
• Diuretics (water pills) or
• Insulin or
• Laxatives (with overdose or chronic misuse) or
• Methazolamide (e.g., Neptazane) or
• Mezlocillin (e.g., Mezlin)
• Piperacillin (e.g., Pipracil) or
• Piperacillin and tazobactam (e.g., Zosyn) or
• Salicylates or
• Sirolimus (e.g., Rapamune) or
• Sodium bicarbonate (e.g., baking soda) or
• Sodium Polystrene Sulfonate (e.g., Kayexalate) or
• Ticarcillin (e.g., Ticar) or
• Ticarcillin and clavulanate (e.g., Timentin) - Fludrocortisone and these medicines decrease the amount of potassium in the blood, which may increase the chance of severe low blood potassium

• Alcohol - Alcohol and fludrocortisone decrease the amount of potassium in the blood, which may increase the chance of severe low blood potassium; alcohol may also make fludrocortisone less effective by causing the body to get rid of it faster

• Barbiturates or
• Carbamazepine (e.g., Tegretol) or
• Efavirenz (e.g., Sustiva) or
• Griseofulvin (e.g., Fulvicin) or
• Modafinil (e.g., Provigil) or
• Nevirapine (e.g., Viramune) or
• Phenylbutazone (e.g., Butazolidin) or
• Phenytoin (e.g., Dilantin)
• Primidone (e.g., Mysoline) or
• Rifabutin (e.g., Mycobutin) or
• Rifampin (e.g., Rifadin)
• Rifapentine (e.g., Priftin) - Using these medicines may make fludrocortisone less effective because they cause the body to get rid of it faster

• Digitalis glycosides (heart medicine) - Fludrocortisone decreases the amount of potassium in the blood, which may increase the chance of irregular heartbeat

• Other corticosteroids (cortisone-like medicine) - Using any corticosteroid medicine with fludrocortisone will cause the body to get rid of both medicines faster. This may make either or both medicines less effective. Also, fludrocortisone and other corticosteroids decrease the amount of potassium in the blood, which may increase the chance of severe low blood potassium

• Sodium-containing medicine - When using fludrocortisone to treat certain types of kidney diseases, too much sodium may cause high blood sodium, high blood pressure, and excess body water

Other medical problems - The presence of other medical problems may affect the use of fludrocortisone. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems - Using fludrocortisone and also using aspirin may cause bleeding problems to become worse.

• Bone disease - Fludrocortisone may make bone disease worse because it causes more calcium to pass into the urine

• Edema (swelling of feet or lower legs) or
• Heart disease or
• High blood pressure or
• Kidney disease - Fludrocortisone causes the body to retain (keep) more salt and water. These conditions may be made worse by this extra body water

• Herpes infection of the eye - may cause a hole in the cornea of the eye.

• Liver disease or
• Abdominal surgery (fresh) or
• Diseases of the intestines or
• Myasthenia gravis or
• Tuberculosis or
• Ulcers in the stomach or intestines - Fludrocortisone suppresses the immune system. Infections with these conditions may be made worse by this suppression.

• Thyroid disease - The body may not get fludrocortisone out of the bloodstream at the usual rate, which may increase the effect of fludrocortisone or cause more side effects