Fludrocortisone

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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. 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.

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

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.


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