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". www.revolvy.com. Retrieved Aug 14, 2018. 
  3. 3.03.1 Peterson, Phillip K.; Pheley, Alfred; Schroeppel, Jill; Schenck, Carlos; Marshall, Paul; Kind, Allan; Haugland, J. Mark; Lambrecht, Lawrence J.; Swan, Suzanne (Apr 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 (Mar 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 Aug 14, 2018. 
  7. "Fludrocortisone Drug Interactions - Drugs.com". Drugs.com. Retrieved Aug 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).

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

adverse reaction - Any unintended or unwanted response to the treatment under investigation in a clinical trial.

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.

National Academy of Medicine (NAM) - An American non-profit, non-governmental organization which provides expert advice to governmental agencies on issues relating to biomedical science, medicine and health. Formerly known as the Institute of Medicine (IOM).

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.