Fludrocortisone.html



Fludrocortisone
Systematic (IUPAC) name
9-fluoro-11,17-dihydroxy-17- (2-hydroxyacetyl)- 10,13-dimethyl- 1,2,6,7,8,9,10,11,12, 13,14,15,16,17- tetradecahydrocyclopenta[a]phenanthren-3-one
Identifiers
CAS number	127-31-1
ATC code	H02AA02
PubChem	31378
DrugBank	APRD00756
Chemical data
Formula	C21H29FO5
Mol. mass	380.45 g/mol
Pharmacokinetic data
Bioavailability	?
Protein binding	High
Metabolism	Hepatic
Half life	3.5 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	C
Legal status
Routes	oral

Fludrocortisone is a synthetic corticosteroid with moderate glucocorticoid potency and much greater mineralocorticoid potency.

The brand name in the U.S. is Florinef.

Uses

It has been used in the treatment of cerebral salt wasting.¹

It is used primarily to replace the missing hormone aldosterone in various forms of adrenal insufficiency such as Addison's disease and the classic salt wasting (21-hydroxylase deficiency) form of congenital adrenal hyperplasia.

It is the first line of treatment for orthostatic intolerance as well.

Dosing

It is available in 0.1 mg tablets. Typical daily doses for mineralocorticoid replacement are between 0.05 mg - 0.2 mg. Renin plasma, sodium, and potassium is checked through blood tests in order to verify that the correct dosage is reached.

Chemical properties

Chemically, its structure is identical to cortisone except for the substitution of fluorine in place of one hydrogen. Fluorine is a good bioisostere for hydrogen because it is similar in size. The major difference is in its electronegativity.

References

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