Fludrocortisone

Fludrocortisone

Drug monograph · NCLEX study reference
Trade names	Florinef
Therapeutic class	Adrenal replacement (mineralocorticoid)
Pharmacologic class	Synthetic mineralocorticoid
Onset / peak / duration	Effect over hours; duration 1 to 2 days.
Half-life / level	Half-life about 3.5 hours; biologic effect longer.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	None.
Pregnancy / lactation	Used when needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Fludrocortisone (brand name Florinef) — Adrenal replacement (mineralocorticoid); Synthetic mineralocorticoid.

Identification

• Therapeutic class: Adrenal replacement (mineralocorticoid).
• Pharmacologic class: Synthetic mineralocorticoid.

Pharmacology

• Mechanism of action: Promotes sodium retention and potassium excretion at the kidney.
• Onset / peak / duration: Effect over hours; duration 1 to 2 days.
• Half-life / therapeutic level: Half-life about 3.5 hours; biologic effect longer.

Clinical use

• Indications: Adrenal insufficiency (Addison disease), salt-wasting congenital adrenal hyperplasia, orthostatic hypotension.
• Usual dose, route, frequency: 0.05 to 0.2 mg PO once daily.
• Maximum dose / adjustments: Titrate to blood pressure and potassium.

Safety

• Contraindications: Systemic fungal infection, heart failure.
• Black box warning: None.
• Interactions: Diuretics (potassium loss), NSAIDs, digoxin (hypokalemia toxicity).
• Pregnancy / lactation: Used when needed.
• High-alert: No.

Adverse effects

• Common side effects: Edema, hypertension, hypokalemia.
• Serious effects to report: Heart failure signs, severe hypokalemia.
• Antidote / reversal: None.

Nursing process

• Assessment before administration: Blood pressure, potassium, edema.
• Interventions during therapy: Monitor for fluid overload.
• Monitor: Blood pressure, potassium, weight, edema.
• Evaluation / expected outcome: Stable blood pressure and electrolytes.

Patient teaching

• Patient teaching: Report swelling or weakness.
• Notify provider if: Swelling, weight gain, muscle weakness.
• Administration tips: Daily, consistent timing.