Medication: Fludrocortisone

What is Fludrocortisone?

Fludrocortisone is a corticosteroid medication prescribed off-licence to manage PoTS symptoms, particularly to address blood pressure drops and improve symptoms related to blood volume and circulation.

What Does “Off-Licence” Mean?

Fludrocortisone is officially licensed in the UK for conditions like adrenal insufficiency. Its use in managing PoTS symptoms is considered off-licence because PoTS is not among its officially approved indications.

How Does Fludrocortisone Work?

Fludrocortisone works by increasing salt and fluid retention in your body. This helps expand blood volume and stabilise blood pressure, reducing symptoms like dizziness, fainting, and rapid heartbeats upon standing. Lifestyle modifications alongside fludrocortisone often enhance symptom relief.

Lifestyle Changes That Help

To support treatment effectiveness, recommended lifestyle changes include:

• Drinking more fluids and increasing salt intake to maintain blood volume
• Eating smaller, more frequent meals
• Using compression garments to improve circulation

Further guidance can be found on the PoTS UK website.

How Do You Take Fludrocortisone?

Fludrocortisone tablets, commonly known by the brand name “Florinef,” are typically prescribed at low doses, starting at 50-100 micrograms daily, usually taken once each morning.

Who Should Not Take Fludrocortisone?

Fludrocortisone should only be used under medical guidance and may not be suitable for those with:

• High blood pressure
• Heart failure
• Kidney or liver impairment
• Severe infections

Always discuss other medications or herbal supplements with your doctor, as interactions may occur. If pregnant or breastfeeding, discuss risks and benefits thoroughly with your healthcare provider.

What Are The Side Effects?

Common side effects include:

• Fluid retention and swelling (particularly ankles)
• Headaches
• Increased blood pressure
• Low potassium levels

Less common side effects include:

• Muscle weakness
• Stomach irritation
• Mood changes

Report any severe or persistent side effects promptly. Serious reactions such as severe blood pressure spikes, severe headaches, or allergic reactions require immediate medical intervention.

Monitoring During Treatment

Regular blood pressure checks, potassium levels, and symptom diaries are recommended during fludrocortisone treatment to monitor effectiveness and manage potential side effects.

How To Get And Store Fludrocortisone

Fludrocortisone is typically prescribed initially by specialists familiar with PoTS, with follow-up prescribing often managed by your GP. It is available via hospital or community pharmacies with NHS or private prescriptions.

Store your medication in a cool, dry place, protected from direct sunlight, and out of children’s reach. Always verify expiry dates before use.

This web page is a brief summary of Fludrocortisone. Always check the Patient Information Leaflet that is provided with your medication for more detailed information.

Additional information

You may be issued with a steroid warning card if you take fludrocortisone for over 3 weeks to warn of possible side effects or complications of fludrocortisone treatment. However, fludrocortisone is a different type of steroid from glucocorticoids (eg prednisolone, hydrocortisone) and the conditions that the steroid card warns of tend to be less severe with fludrocortisone than for glucocorticoids.