Florinef (fludrocortisone)

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Sodium and water retention.

Swelling due to fluid retention (oedema).

High blood pressure (hypertension).

Headache.

Low blood potassium level (hypokalaemia).

Muscle weakness.

Fatigue.

Increased susceptibility to infection.

Impaired wound healing.

Increased sweating.

Increased hair growth (hirsutism).

Thinning of skin and stretch marks.

Disturbances of the gut such as indigestion (dyspepsia), distention of the abdomen and ulceration (peptic ulcer).

Decreased bone density and increased risk of fractures of the bones.

Difficulty in sleeping (insomnia).

Depression.

Weight gain.

Raised blood sugar level.

Changes to your menstrual cycle.

Partial loss of vision due to opacity in the lens of the eye (cataracts).

Raised pressure in the eye (glaucoma).

Increased pressure in the skull (intracranial pressure).

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines may increase the removal of fludrocortisone from the body, thus reducing its effects. You may need a larger dose of fludrocortisone if you are also taking any of these medicines:

antiepileptic medicines such as carbamazepine, phenytoin, phenobarbital and primidone

barbituates such as amobarbital

rifamycin antibiotics such as rifampicin or rifabutin.

The following medicines may increase the blood level of fludrocortisone and so may increase its effects or side effects:

ciclosporin (fludrocortisone may also increase the risk of side effects caused by ciclosporin)

oestrogen-containing contraceptives

the antifungal ketoconazole.

Fludrocortisone can cause fluid and salt retention and so may oppose the effects of the following medicines:

antihypertensive medicines used to treat high blood pressure

diuretics, eg furosemide.

Fludrocortisone may increase blood sugar levels and so may oppose the blood sugar lowering effects of antidiabetic medicines. People with diabetes may need an increase in their dose of insulin or antidiabetic tablets.

There may be an increased risk of low blood potassium levels (hypokalaemia) if fludrocortisone is taken in combination with any of the following medicines (which can also lower the amount of potassium in the blood):

acetazolamide

amphotericin

carbenoxolone

potassium-losing diuretics, eg furosemide, bendroflumethiazide.

If fludrocortisone is taken in combination with non-steroidal anti-inflammatory drugs (NSAIDs) eg ibuprofen, there may be an increased risk of side effects on the gut, such as stomach ulceration and bleeding.

Fludrocortisone may affect the anti-blood-clotting effect of anticoagulant medicines such as warfarin. People taking fludrocortisone in combination with warfarin should have their blood clotting time (INR) regularly monitored, particularly after any dose changes.

Fludrocortisone may decrease the blood levels of salicylates such as aspirin. If fludrocortisone is stopped, this may result in excessive levels of the salicylate.

Fludrocortisone may decrease the body's immune response. This means that vaccines may be less effective if given during treatment, because the body does not produce sufficient antibodies. Live vaccines may cause serious infections. Live vaccines include: measles, mumps, rubella, MMR, oral polio, oral typhoid and yellow fever. These should not be given to people taking this medicine.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain fludrocortisone as the active ingredient.

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