Mineralocorticoid therapy (Formulary)

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card. This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids. For more information, including which patients should receive the card, see HIS for details. Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

See Peri-operative guidelines for patients with or at risk of adrenal insufficiency

FLUDROCORTISONE

Important: Therapy notes

The tablets should be stored in the refrigerator between 2 and 8˚C.

Important: Formulation and dosage details

Formulation:

Tablets 100 micrograms

Dosage:

50 to 200 micrograms daily.

Patients with Addison’s disease (primary adrenocortical insufficiency) require mineralocorticoid replacement with fludrocortisone normally in a dose of 50 to 200 micrograms daily. The adequacy of replacement can be assessed by measurement of plasma renin activity and clinically through postural blood pressure measurement and assessment of oedema.

For use in orthostatic hypotension off-label refer to Parkinson's Disease guideline.