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In generaldose selection for an elderly patient should be cautioususually starting at the low end of the dosing rangereflecting the greater frequency of decreased hepaticrenalor cardiac functionand of concomitant disease or other drug therapy.

The physiologic action of fludrocortisone acetate is similar to that of hydrocortisoneHoweverthe effects of fludrocortisone acetateparticularly on electrolyte balancebut also on carbohydrate metabolismare considerably heightened and prolongedMineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasmathey increase the urinary excretion of both potassium and hydrogen ionsThe consequence of these three primary effects together with similar actions on cation transport in other tissues appear to account for the entire spectrum of physiological activities that are characteristic of mineralocorticoidsIn small oral dosesfludrocortisone acetate produces marked sodium retention and increased urinary potassium excretionIt also causes a rise in blood pressureapparently because of these effects on electrolyte levels.

Children who are on immunosuppressant drugs are more susceptible to infections than healthy childrenChicken pox and measlesfor examplecan have a more serious or even fatal course in children on immunosuppressant corticosteroidsIn such childrenor in adults who have not had these diseasesparticular care should be taken to avoid exposureIf exposedtherapy with varicella zoster immune globulinVZIGor pooled intravenous immunoglobulinIVIGas appropriatemay be indicatedIf chicken pox developstreatment with antiviral agents may be considered.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

When fludrocortisone is used in the small dosages recommendedthe glucocorticoid side effects often seen with cortisone and its derivatives are not usually a problemhowever the following untoward effects should be kept in mindparticularly when fludrocortisone is used over a prolonged period of time or in conjunction with cortisone or a similar glucocorticoid.

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