Fludrocortisone Acetate (Florinef)

Overview 

• Addison's disease  – more properly known as hypoadrenocorticism –  is a deficiency of hormones (cortisol, aldosterone) normally produced by the adrenal gland. 

• Consequences of  this disorder can include extreme weakness, shock, vomiting, diarrhea, disturbances of blood potassium and sodium, abnormal heart rhythms and death. 

• Hypoadrenocorticism in dogs is an autoimmune disease that leads  to destruction of the adrenal gland cortex (outer layers) and a deficiency  of vital hormones. 

• One of the hormones produced by the adrenal glands. 

• and absent in Addison's disease is aldosterone. This hormone assists the kidney in retaining needed sodium  and losing  excessive potassium. 

• Deficiency  of the hormone increases  sodium loss  in the urine, reduces blood pressure and increases blood potassium. High blood potassium can be dangerous, leading to fatal cardiac arrhythmias. 

• Treatment of Addison's disease requires replacement of missing hormones.  It is essential to replace aldosterone with a similar hormone. 

• Fludrocortisone acetate is a synthetic hormone used in  the treatment of mineralocorticoid deficiency (also called Addison's disease)  in small animals.

• Fludrocortisone is  a prescription drug and can only  be obtained from a veterinarian or  by prescription from  a veterinarian. 

• This drug  is not approved  for use in animals by  the Food  and Drug Administration but  it is  prescribed legally by veterinarians as an extra-label drug. 

• This  drug is registered for use in humans only. 
• Human formulations: Florinef® (Apothecon) 
• Veterinary formulations: None 

• Fludrocortisone  is used in  the treatment  of mineralocorticoid deficiency (Addison's disease). 

• While generally safe and effective when prescribed by a veterinarian, fludrocortisone can cause side effects  in some animals. 
• Fludrocortisone should not be used in animals with known hypersensitivity or allergy to  the drug. 
• Fludorcortisone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with fludrocortisone. Such drugs include furosemide, insulin  and amphotericin B. 
• If the animal does not receive a sufficient dose  of fludrocortisone, loss  of appetite (anorexia), vomiting, diarrhea, weakness  and depression may result. 
• Overdose of fludrocortisone can result  in excessive thirst, low blood potassium, and high blood sodium. 
• Blood tests must be done regularly  to monitor  the effects  of treatment. 

• Fludrocortisone  is available in 0.1 mg tablets. 

• Medication  should never be administered without first consulting your veterinarian. 
• The typical daily  dose administered  to dogs for maintenance treatment of Addison's disease is one to four tablets depending on body weight and response to treatment. 
• For cats  the typical dose is 0.1 mg (1 tablet) daily depending  on body weight. 
• Final dose adjustments are made on  the base of blood tests that measure electrolytes (sodium, potassium). 
• Many animals undergoing treatment for Addison's disease also require glucocorticoid drugs that  are similar to cortisone. These include prednisolone and methylprednisolone. 
• The duration  of administration depends on the condition being treated, response to the medication  and the development of  any adverse effects. Be certain  to complete the prescription unless specifically directed by  your veterinarian. Even  if your pet feels better, the entire treatment plan should be completed to prevent relapse  or prevent the development  of resistance.