Fludrocortisone

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Fludrocortisone (brand name: Florinef) is a synthetic corticosteroid hormone used in treatment of postural hypotension and adrenal insufficiency, including Addison's disease. It is frequently used off-label as a treatment for postural orthostatic tachycardia syndrome (POTS) and orthostatic intolerance (OI). In adrenal insufficiency, it is generally taken together with hydrocortisone.

Fludrocortisone is mostly a mineralocorticoid, but it has very weak glucocorticoid effects.[1] It mimics the function of aldosterone, increasing blood sodium levels and therefore, blood volume.[2]

Use in chronic fatigue syndrome[edit | edit source]

*In 1998, a study by Phillip K. Peterson, et al, showed that low-dose fludrocortisone does not provide sufficient benefit to patients with chronic fatigue syndrome. Using the 36-Item Short-Form Health Survey, a reaction time test, and a treadmill exercise test, they found no observed improvement in the severity of any symptom. Likewise, blood pressure and heart rate readings were unaffected by treatment.[3]

ME/CFS patients often have OI or POTS and these conditions could improve by taking fludrocortisone.[4][5]

Side effects and drug interactions[edit | edit source]

It is important to discuss fludrocortisone's side effects[6] and possible drug interactions[7] with your doctor and pharmacist.

Notable studies[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. ↑ Chrousos, George; Pavlaki, Aikaterini N.; Magiakou, Maria Alexandra (2000). De Groot, Leslie J.; Chrousos, George; Dungan, Kathleen; Feingold, Kenneth R.; Grossman, Ashley; Hershman, Jerome M.; Koch, Christian; Korbonits, Márta; McLachlan, Robert (eds.). "Glucocorticoid Therapy and Adrenal Suppression". Endotext. South Dartmouth (MA): MDText.com, Inc. PMID 25905379 – via NCBI NLM NIH Bookshelf.
  2. ↑ LLC, Revolvy. ""Fludrocortisone" on Revolvy.com". revolvy.com. Retrieved August 14, 2018.
  3. ↑ 3.0 3.1 Peterson, Phillip K.; Pheley, Alfred; Schroeppel, Jill; Schenck, Carlos; Marshall, Paul; Kind, Allan; Haugland, J. Mark; Lambrecht, Lawrence J.; Swan, Suzanne (April 27, 1998). "A Preliminary Placebo-Controlled Crossover Trial of Fludrocortisone for Chronic Fatigue Syndrome". Archives of Internal Medicine. 158 (8): 908. doi:10.1001/archinte.158.8.908. ISSN 0003-9926.
  4. ↑ "Proposed Diagnostic Criteria for ME/CFS". nationalacademiesofmedicine.org. 2015.
  5. ↑ Wright Clayton, Ellen; Algeria, Margarita; Bateman, Lucinda; Chu, Lily; Cleeland, Charles; Davis, Ronald; Diamond, Betty; Ganiats, Theodore; Keller, Betsy (March 16, 2015). Nancy Klimas; A Martin Lerner; Cynthia Murlow; Benjamin Natelson; Peter Rowe; Michale Shelanski. "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". National Academy of Medicine Education: 107–119. doi:10.17226/19012 – via NAP.EDU.
  6. ↑ "Fludrocortisone Side Effects in Detail - Drugs.com". Drugs.com. Retrieved August 14, 2018.
  7. ↑ "Fludrocortisone Drug Interactions - Drugs.com". Drugs.com. Retrieved August 14, 2018.

postural orthostatic tachycardia syndrome (POTS) - A form of orthostatic intolerance where the cardinal symptom is excessive tachycardia due to changing position (e.g. from lying down to sitting up).

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute

adverse reaction Any unintended or unwanted response to a treatment, whether in a clinical trial or licensed treatment. May be minor or serious.

National Institutes of Health (NIH) - A set of biomedical research institutes operated by the U.S. government, under the auspices of the Department of Health and Human Services.

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