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Fludrocortisone Acetate (Florinef®)

By: Dr. Karin Szust

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Overview

  • Addison's disease – more properly known as hypoadrenocorticism – is a deficiency of hormones (cortisol, aldosterone) normally produced by the adrenal gland.
  • Consequences of this disorder can include extreme weakness, shock, vomiting, diarrhea, disturbances of blood potassium and sodium, abnormal heart rhythms and death.
  • Hypoadrenocorticism in dogs is an autoimmune disease that leads to destruction of the adrenal gland cortex (outer layers) and a deficiency of vital hormones.
  • One of the hormones produced by the adrenal glands and absent in Addison's disease is aldosterone. This hormone assists the kidney in retaining needed sodium and losing excessive potassium.
  • Deficiency of the hormone increases sodium loss in the urine, reduces blood pressure and increases blood potassium. High blood potassium can be dangerous, leading to fatal cardiac arrhythmias.
  • Treatment of Addison's disease requires replacement of missing hormones. It is essential to replace aldosterone with a similar hormone.
  • Fludrocortisone acetate is a synthetic hormone used in the treatment of mineralocorticoid deficiency (also called Addison's disease) in small animals.
  • Fludrocortisone is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Florinef® (Apothecon)
  • Veterinary formulations: None

    Uses of Fludrocortisone

  • Fludrocortisone is used in the treatment of mineralocorticoid deficiency (Addison's disease).

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, fludrocortisone can cause side effects in some animals.
  • Fludrocortisone should not be used in animals with known hypersensitivity or allergy to the drug.
  • Fludorcortisone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with fludrocortisone. Such drugs include furosemide, insulin and amphotericin B.
  • If the animal does not receive a sufficient dose of fludrocortisone, loss of appetite (anorexia), vomiting, diarrhea, weakness and depression may result.
  • Overdose of fludrocortisone can result in excessive thirst, low blood potassium, and high blood sodium.
  • Blood tests must be done regularly to monitor the effects of treatment.

    How Fludrocortisone Is Supplied

  • Fludrocortisone is available in 0.1 mg tablets.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.
  • The typical daily dose administered to dogs for maintenance treatment of Addison's disease is one to four tablets depending on body weight and response to treatment.
  • For cats the typical dose is 0.1 mg (1 tablet) daily depending on body weight.
  • Final dose adjustments are made on the base of blood tests that measure electrolytes (sodium, potassium).
  • Many animals undergoing treatment for Addison's disease also require glucocorticoid drugs that are similar to cortisone. These include prednisolone and methylprednisolone.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.





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